A nurse in a prenatal clinic is discussing the risks of twin to twin transfusion syndrome with an 18 week pregnant client with monochorionic-monoamniotic (mono-mono) twins.
Which of the following statements by the client shows an understanding of the education?
"My twins are at higher risk of twin to twin transfusion because they share a placenta.”.
"Twin to twin transfusion results in over perfusion to both babies causing circulatory overload and CHF.”.
"Twin to twin transfusion is very common in all multiple gestation pregnancies.”.
"My twins are at a lower risk for twin to twin transfusion because they share the placenta.”. .
The Correct Answer is A
Choice A rationale
Monochorionic-monoamniotic twins share a single placenta and amniotic sac, increasing the risk for twin to twin transfusion syndrome (TTTS). This condition occurs due to unbalanced blood flow through the shared placenta, leading to discrepancies in blood volume between the twins.
Choice B rationale
TTTS does not result in overperfusion to both babies. Instead, it causes one twin (the donor) to become underperfused, leading to anemia and growth restriction, while the other twin (the recipient) becomes overperfused, causing polycythemia and circulatory overload, which can lead to heart failure.
Choice C rationale
TTTS is not very common in all multiple gestation pregnancies; it primarily affects monochorionic twins. In dichorionic twins, each twin has its own placenta, making TTTS highly unlikely.
Choice D rationale
Monochorionic twins sharing a placenta actually increases their risk for TTTS, not lowers it. The shared placenta creates a scenario where blood vessels can cross and lead to uneven blood flow between the twins. .
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Intraamniotic infection (chorioamnionitis) is suspected due to the combination of prolonged rupture of membranes (25 hours), maternal fever (39.2°C), and fetal tachycardia (baseline of 175 bpm). These are key indicators of infection within the amniotic sac.
Choice B rationale
Pyelonephritis, an infection of the kidneys, is unlikely without the presence of symptoms such as flank pain, dysuria, and significant changes in urinalysis. The primary signs point towards intraamniotic infection.
Choice C rationale
Cholestasis of pregnancy primarily presents with intense itching, especially on the hands and feet, and does not typically involve fever or abnormal fetal heart rates. Thus, it is less likely in this scenario.
Choice D rationale
Placental abruption involves the separation of the placenta from the uterine wall before delivery, often presenting with abdominal pain, vaginal bleeding, and uterine contractions. The absence of these symptoms makes this diagnosis less likely.
Correct Answer is A
Explanation
Choice A rationale
Monochorionic-monoamniotic twins share a single placenta and amniotic sac, increasing the risk for twin to twin transfusion syndrome (TTTS). This condition occurs due to unbalanced blood flow through the shared placenta, leading to discrepancies in blood volume between the twins.
Choice B rationale
TTTS does not result in overperfusion to both babies. Instead, it causes one twin (the donor) to become underperfused, leading to anemia and growth restriction, while the other twin (the recipient) becomes overperfused, causing polycythemia and circulatory overload, which can lead to heart failure.
Choice C rationale
TTTS is not very common in all multiple gestation pregnancies; it primarily affects monochorionic twins. In dichorionic twins, each twin has its own placenta, making TTTS highly unlikely.
Choice D rationale
Monochorionic twins sharing a placenta actually increases their risk for TTTS, not lowers it. The shared placenta creates a scenario where blood vessels can cross and lead to uneven blood flow between the twins. .
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