A nurse is teaching the parents of a newborn about the critical congenital heart disease screening.
Which of the following statements should the nurse include in the teaching?

The test will be performed when your newborn is between 6 and 12 hours of age.

It will take 1 to 2 weeks to obtain the results of your newborn's test.

The test compares the oxygen saturation in your newborn's upper and lower extremities.

To perform the test, I will collect a blood sample from your newborn's heel.

Answer and Explanation

The Correct Answer is C

Choice A rationale

The critical congenital heart disease (CCHD) screening is typically performed when the newborn is between 24 and 48 hours of age, or just prior to discharge if that occurs earlier. Performing the test too early, such as between 6 and 12 hours, might yield false negative results due to the persistence of transitional circulation.

Choice B rationale

The results of the CCHD screening are typically available immediately, or within a few minutes, as it involves pulse oximetry readings. There is no waiting period of 1 to 2 weeks for the results, allowing for prompt identification and management of potential cardiac defects, preventing delays in care.

Choice C rationale

The CCHD screening specifically compares the oxygen saturation in the newborn's right hand (pre-ductal) and either foot (post-ductal). A significant difference between these two readings can indicate a shunt or obstruction within the heart or great vessels, suggesting a potential critical congenital heart defect.

Choice D rationale

Collecting a blood sample from the newborn's heel is the procedure for the newborn metabolic screening, which screens for various genetic and metabolic disorders, not the critical congenital heart disease screening. The CCHD screening is a non-invasive test performed using pulse oximetry.

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Correct Answer is D

Explanation

A. The bladder is distended upon palpation: A distended bladder suggests urinary retention, not effective voiding. This may impair uterine contraction and increase the risk of hemorrhage.
B. The uterine fundus is 2 cm above the umbilicus: A high-rising fundus may indicate a full bladder that is displacing the uterus, often due to incomplete voiding.
C. The client does not feel the urge to urinate: Lack of urge may indicate altered bladder sensation, a potential complication after catheter removal and childbirth.
D. The client urinates 30 mL/hr: Urine output of ≥30 mL/hr is considered adequate and reflects effective voiding and kidney function, especially in the postpartum period.

A. A client who is at 12 weeks of gestation and reports not having felt the fetus move. B. A client who is at 28 weeks of gestation and has a fetal heart rate of 160/min via Doppler. C. A client who is at 38 weeks of gestation and has 2+ deep tendon reflexes. D. A client who is at 36 weeks of gestation and reports blurred vision.

Correct Answer is D

Explanation

Choice A rationale

A client at 12 weeks of gestation not feeling fetal movement is expected. Fetal movement, or quickening, typically begins between 16 and 20 weeks of gestation for primigravidas and earlier for multigravidas. At 12 weeks, the fetus is still small and movements are not usually strong enough to be consistently perceived by the mother, thus this finding is not immediately concerning.

Choice B rationale

A fetal heart rate (FHR) of 160/min at 28 weeks of gestation is within the normal range, which is typically 110-160 beats/min. A normal FHR indicates adequate fetal oxygenation and well-being. Therefore, this finding does not suggest an emergent situation requiring immediate provider assessment.

Choice C rationale

Deep tendon reflexes (DTRs) graded as 2+ are considered normal. This grading indicates an average, brisk reflex response. Abnormal DTRs, such as hyperreflexia (3+ or 4+), can be indicative of preeclampsia, but a 2+ finding is physiological and does not warrant immediate concern.

Choice D rationale

Blurred vision in a client at 36 weeks of gestation can be a symptom of preeclampsia, a serious hypertensive disorder of pregnancy. This condition can lead to severe complications such as eclampsia, placental abruption, or HELLP syndrome, requiring immediate medical evaluation and intervention to prevent adverse maternal and fetal outcomes.

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A nurse is teaching the parents of a newborn about the critical congenital heart disease screening. Which of the following statements should the nurse include in the teaching?

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A nurse is teaching the parents of a newborn about the critical congenital heart disease screening.
Which of the following statements should the nurse include in the teaching?