A newborn’s assessment reveals spina bifida occulta.
Which maternal factor should the nurse identify as having the greatest impact on the development of this newborn complication?

Preeclampsia

Tobacco use

Folic acid deficiency

Short interval pregnancy

Answer and Explanation

The Correct Answer is C

Choice A rationale
Preeclampsia is a pregnancy complication characterized by high blood pressure and signs of damage to another organ system, often the liver and kidneys. While it can have serious implications for the mother and baby, it is not directly linked to the development of spina bifida occulta in the newborn.
Choice B rationale
Tobacco use during pregnancy can lead to several complications, including low birth weight, preterm birth, and certain birth defects. However, it is not identified as a significant risk factor for spina bifida occulta.
Choice C rationale
Folic acid deficiency during pregnancy is a well-known risk factor for neural tube defects, including spina bifida. Spina bifida occulta is a mild form of spina bifida caused by a gap forming between the vertebrae in the spinal cord during fetal development. Adequate intake of folic acid, especially during the early stages of pregnancy, can help prevent such defects.
Choice D rationale
Short interval pregnancy refers to pregnancies that are closely spaced. While they can lead to complications such as preterm birth and low birth weight, they are not directly associated with an increased risk of spina bifida occulta.

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Correct Answer is {"dropdown-group-1":"C"}

Explanation

A. Croup

Rationale: Croup is a condition characterized by a barking cough and stridor (a high-pitched breathing sound), often accompanied by noisy breathing. It is a common cause of respiratory distress in children and can present with symptoms similar to those described.

B. Asthma

Rationale: Asthma can present in young children with symptoms such as wheezing, shortness of breath, and rapid breathing. However, diagnosing asthma in very young children can be challenging due to the variability of symptoms and the overlap with other respiratory conditions.

C. Bronchiolitis

Rationale: The child’s symptoms of “fast and noisy breathing” could be indicative of bronchiolitis, a common lung infection in young children. This condition is often preceded by symptoms of a common cold, such as sneezing and a runny nose, which the child had the previous week.

D. Foreign Body Aspiration

Rationale: Foreign body aspiration should be considered in young children who present with sudden onset of respiratory symptoms, including noisy or rapid breathing, particularly if there is a history of coughing or choking.

A. Praise the client for her actions and offer to discuss ways to decrease consumption even more. B. Insist that the client stop all alcohol use and draw a blood alcohol level at each prenatal visit. C. Notify child protective services of the client’s illicit drug use and probable child endangerment. D. Refer the client to an outpatient alcohol abuse program for disulfiram therapy.

Correct Answer is A

Explanation

The correct answer is A. Praise the client for her actions and offer to discuss ways to decrease consumption even more.

Why? During pregnancy, any amount of alcohol poses a risk to the developing fetus, but abruptly shaming or forcing action may not be effective. The best approach is motivational interviewing, which involves acknowledging the client's reduction while encouraging further progress. A supportive conversation can help guide the client toward complete cessation of alcohol use.

Here’s why the other options are incorrect:

B. Insist that the client stop all alcohol use and draw a blood alcohol level at each prenatal visit – While alcohol cessation is the goal, forcing the client without a supportive approach can lead to resistance. Routine blood alcohol testing is not standard unless substance dependence is suspected.
C. Notify child protective services of the client’s illicit drug use and probable child endangerment – Alcohol is not classified as an illicit drug, and reporting at this stage would be premature unless clear evidence of abuse or harm to the fetus exists.
D. Refer the client to an outpatient alcohol abuse program for disulfiram therapy – Disulfiram (Antabuse) is not recommended in pregnancy, as it may cause adverse effects. Instead, behavioral counseling and support groups are preferred interventions.

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A newborn’s assessment reveals spina bifida occulta. Which maternal factor should the nurse identify as having the greatest impact on the development of this newborn complication?

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Correct Answer is {"dropdown-group-1":"C"}

Explanation

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A newborn’s assessment reveals spina bifida occulta.
Which maternal factor should the nurse identify as having the greatest impact on the development of this newborn complication?