A nurse is caring for a woman at 32 weeks gestation who asks why she needs to lie on her side during the nonstress test.
Using knowledge of placental function, which explanation by the nurse is MOST accurate?

Side-lying prevents the placenta from separating from the uterine wall.

This position improves blood flow through the placenta to deliver oxygen to your baby.

Lying on your side helps the placenta filter out harmful substances more effectively.

Side-lying allows air to pass through the placenta more easily.

Answer and Explanation

The Correct Answer is B

Choice A rationale

Placental abruption occurs when the placenta detaches prematurely from the uterine wall, typically due to hypertension, trauma, or cocaine use. Side-lying does not physically anchor the placenta or prevent this mechanical separation. The primary concern during a nonstress test is ensuring adequate fetal oxygenation through optimal perfusion rather than preventing structural detachment of the placenta, which is governed by different physiological and pathological triggers during the third trimester.

Choice B rationale

The gravid uterus can compress the inferior vena cava and aorta when the mother is supine, leading to decreased venous return and maternal hypotension. This reduces uterine blood flow and placental perfusion. Side-lying, especially on the left, relieves this pressure, maximizing blood flow through the spiral arteries into the intervillous space. This ensures a steady delivery of oxygenated blood to the fetus, which is critical for an accurate and reactive nonstress test result.

Choice C rationale

The placenta functions as a semi-permeable membrane using passive diffusion, facilitated diffusion, and active transport to move nutrients and waste. While it acts as a barrier to some pathogens and large molecules, its filtering efficiency is determined by the health of the syncytiotrophoblast and molecular size, not maternal positioning. Side-lying optimizes the volume of blood reaching the placenta but does not change the inherent biochemical or cellular mechanism used to filter harmful substances.

Choice D rationale

The placenta does not facilitate the passage of air or gaseous oxygen in a literal sense like the lungs. Instead, oxygen is dissolved in the maternal blood and transferred to fetal hemoglobin across the placental membrane via a partial pressure gradient. Side-lying improves the delivery of the medium carrying the oxygen, which is the blood, but it does not facilitate the movement of air, as the fetal environment remains entirely fluid-filled and aquatic.

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Correct Answer is C

Explanation

Choice C rationale

Evaporation is the loss of heat that occurs when liquid is converted to vapor. At birth, the infant is covered in amniotic fluid; as this fluid evaporates from the skin, it pulls significant heat away from the body. Drying the infant immediately and thoroughly with warm blankets is the primary nursing intervention to stop this process. This prevents cold stress, which can lead to increased oxygen consumption and metabolic acidosis in the newborn.

Choice D rationale

Warming the crib pad is an intervention specifically designed to prevent heat loss through conduction. Conduction is the transfer of heat from the newborn's body to a cooler solid surface in direct contact with the skin. While maintaining a warm sleep surface is an important part of thermoregulation, it does not address the moisture-based heat loss associated with evaporation. The removal of moisture from the skin is the only way to mitigate evaporative cooling.

A. Prevent infant falls by teaching safe handling. B. Prevent hypoglycemia by ensuring frequent feedings. C. Prevent SIDS by teaching safe sleep practices. D. Prevent abusive head trauma by helping parents understand normal infant crying.

Correct Answer is D

Explanation

Choice A rationale

While infant falls are a significant safety concern in the postpartum period and early childhood, the Period of PURPLE Crying program is not specifically focused on mechanical safety or physical handling techniques. Falls are usually addressed through general safety teaching regarding furniture, stairs, and carrying techniques. This specific educational program targets the psychological and behavioral aspects of responding to a crying infant rather than the physical prevention of accidental falls or drops in the home environment.

Choice B rationale

Hypoglycemia prevention is a critical aspect of early neonatal care, but it is managed through feeding education and monitoring of glucose levels rather than through a video about crying patterns. The physiology of blood sugar regulation is unrelated to the behavioral education provided in the PURPLE Crying curriculum. Feeding schedules are discussed in the context of nutrition and growth, whereas this video focuses on the emotional and developmental challenges parents face when an infant cries excessively.

Choice C rationale

Sudden Infant Death Syndrome (SIDS) prevention is addressed through the Safe to Sleep campaign, which emphasizes supine positioning, firm sleep surfaces, and the avoidance of loose bedding. While both programs are essential for newborn safety, they target different risks. The PURPLE Crying program does not provide instruction on sleep environments or SIDS risk factors, as its primary goal is to educate parents on the developmental phase of increased crying to prevent caregiver frustration and potential abuse.

Choice D rationale

The Period of PURPLE Crying is a specialized evidence-based program designed to prevent Shaken Baby Syndrome and abusive head trauma. It educates parents that crying is a normal developmental phase that often increases at 2 weeks of age and peaks at 2 months. By explaining that crying can be inconsolable and is not a reflection of poor parenting, the program helps reduce the frustration and anger that can lead a caregiver to shake or harm an infant.

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A nurse is caring for a woman at 32 weeks gestation who asks why she needs to lie on her side during the nonstress test. Using knowledge of placental function, which explanation by the nurse is MOST accurate?

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A nurse is assisting with the delivery of a newborn in the delivery room. How can the nurse prevent heat loss in the newborn resulting from evaporation?

Correct Answer is C

Explanation

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Correct Answer is D

Explanation

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A nurse is caring for a woman at 32 weeks gestation who asks why she needs to lie on her side during the nonstress test.
Using knowledge of placental function, which explanation by the nurse is MOST accurate?