A nurse should include which of the following information?

Choice A rationale:

Maternal battering, or physical abuse during pregnancy, is a risk factor for placental abruption. However, it is not the most common risk factor. Studies have shown that the incidence of placental abruption is about 2-4 times higher in women who have experienced physical abuse during pregnancy compared to those who have not. However, the overall prevalence of physical abuse during pregnancy is estimated to be around 4-8%, while the prevalence of maternal hypertension is much higher, affecting about 10-15% of pregnancies.

Choice B rationale:

Cigarette smoking is also a risk factor for placental abruption. The nicotine in cigarettes causes vasoconstriction, which can reduce blood flow to the placenta. This can lead to placental abruption, especially in women who smoke heavily. However, while smoking is a significant risk factor, it is still less common than maternal hypertension.

Choice C rationale:

Maternal age is associated with an increased risk of placental abruption. Women over the age of 35 are at a higher risk than younger women. This is likely due to changes in the blood vessels of the uterus that occur with age. However, age alone is not as strong a predictor as hypertension.

Choice D rationale:

Maternal cocaine use is a significant risk factor for placental abruption. Cocaine causes vasoconstriction and can also lead to high blood pressure. This combination of factors can significantly increase the risk of placental abruption. However, cocaine use is much less prevalent than hypertension in the general population.

Choice E rationale:

Maternal hypertension, or high blood pressure during pregnancy, is the most common risk factor for placental abruption. Hypertension can damage the blood vessels in the uterus, which can lead to placental abruption. Approximately 50% of placental abruptions are associated with hypertension.

Rationale for Choice A:
Judgmental and shaming: The statement "You are so young. Are you sure you are ready for the responsibilities of a sexual relationship?" conveys judgment and may make the adolescent feel ashamed or embarrassed. This can create a barrier to open communication and discourage the teen from seeking further guidance.
Dismisses the teen's concerns: It does not directly address the teen's question about contraception, suggesting that her concerns are not valid or important.
Does not provide helpful information: It does not offer any guidance or education about contraception, leaving the teen without the information she needs to make informed decisions about her sexual health.

Rationale for Choice B:
Erects barriers to access: Requiring parental consent for an examination can delay or prevent the teen from obtaining contraception, even if she is legally allowed to do so without parental consent.
Discourages open communication: It may make the teen feel like she cannot trust the nurse or that her privacy will not be respected, leading her to withhold information or avoid seeking further help.

Rationale for Choice C:
Defers responsibility: It shifts the responsibility for providing contraception counseling to the doctor, potentially delaying the teen's access to information and services.
May not be necessary: A physical examination is not always required before prescribing contraception, and in some cases, a nurse practitioner or other qualified health professional can provide this service.

Rationale for Choice D:
Open and non-judgmental: It invites the teen to share information about her sexual activity without judgment or pressure. Gathers essential information: It allows the nurse to assess the teen's individual needs and preferences, which is crucial for recommending the most appropriate contraceptive method.
Promotes informed decision-making: It empowers the teen to make informed choices about her sexual health by providing her with accurate and comprehensive information about contraception.