A nursing student asks the nurse why more is not known about the teratogenic effects of maternal medication ingestion during pregnancy. Which response by the nurse is correct?
“Clinical trials to assess this risk would put the fetus at risk.”
“The relatively new FDA study will allow testing of medications during pregnancy in the future.”
“Most women are reluctant to admit taking medications while they are pregnant.”
“It is safer to recommend that pregnant women avoid medications while pregnant.”
The Correct Answer is A
Choice A Reason:
Clinical trials to assess the teratogenic effects of medications during pregnancy are ethically challenging because they would involve exposing pregnant women and their fetuses to potential risks. The primary concern is the safety of the fetus, as many drugs can cross the placenta and potentially cause harm. Therefore, most of the data on teratogenic effects come from observational studies, case reports, and animal studies rather than controlled clinical trials.
Choice B Reason:
While the FDA has initiatives to improve the safety of medications during pregnancy, it is not accurate to say that a new study will allow testing of medications during pregnancy in the future. The ethical concerns surrounding the exposure of pregnant women to potential teratogens remain a significant barrier. Current efforts focus on improving post-marketing surveillance and encouraging the reporting of adverse effects to gather more data.
Choice C Reason:
Although some women may be reluctant to admit taking medications during pregnancy, this is not the primary reason for the lack of data on teratogenic effects. The main issue is the ethical and practical challenges of conducting clinical trials in pregnant women. Reluctance to report medication use can contribute to underreporting, but it is not the central factor.
Choice D Reason:
Recommending that pregnant women avoid medications is a general precaution, but it does not address the reason why more is not known about teratogenic effects. The avoidance of medications is advised to minimize potential risks, but the lack of data is primarily due to the ethical constraints of conducting clinical trials in this population.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A: Hypoventilation
Hypoventilation refers to inadequate ventilation that leads to an increased concentration of carbon dioxide (CO2) in the blood, resulting in respiratory acidosis. This condition is characterized by a decrease in blood pH due to the accumulation of CO2, which forms carbonic acid. Hypoventilation does not cause metabolic acidosis, as it primarily affects the respiratory component of acid-base balance.
Choice B: Massive Blood Transfusion
Massive blood transfusion can lead to metabolic alkalosis rather than metabolic acidosis. This is because stored blood products often contain citrate, which is metabolized to bicarbonate in the liver, increasing the blood’s alkalinity. Additionally, the transfusion of large volumes of blood can dilute the plasma bicarbonate concentration, but this typically does not result in metabolic acidosis.
Choice C: Kidney Failure
Kidney failure is a common cause of metabolic acidosis. The kidneys play a crucial role in maintaining acid-base balance by excreting hydrogen ions (H+) and reabsorbing bicarbonate (HCO3-). When the kidneys fail, they are unable to remove sufficient acids from the blood, leading to an accumulation of metabolic acids and a decrease in blood pH. This condition is known as metabolic acidosis and can result from chronic kidney disease (CKD) or acute kidney injury (AKI).
Choice D: Hyperventilation
Hyperventilation leads to respiratory alkalosis, not metabolic acidosis. This condition occurs when there is excessive ventilation, causing a decrease in CO2 levels in the blood and an increase in blood pH. Hyperventilation reduces the concentration of carbonic acid, leading to an alkaline state. It does not contribute to metabolic acidosis, which involves an imbalance in the metabolic components of acid-base regulation.
Correct Answer is D
Explanation
Choice A: Calcium
Calcium plays a crucial role in various physiological processes, including muscle contraction, blood clotting, and nerve transmission. While calcium is essential for maintaining overall health, it is not directly associated with changes in blood pH. Calcium levels are tightly regulated by hormones such as parathyroid hormone (PTH) and calcitonin, but these do not significantly influence blood pH.
Choice B: Sodium
Sodium is a major extracellular electrolyte that helps regulate fluid balance, nerve function, and muscle contraction. Although sodium is vital for maintaining osmotic balance and blood pressure, it does not directly affect blood pH. Sodium levels are primarily controlled by the kidneys and hormones like aldosterone, which do not have a direct impact on the acid-base balance of the blood.
Choice C: Magnesium
Magnesium is involved in over 300 biochemical reactions in the body, including protein synthesis, muscle and nerve function, and blood glucose control. While magnesium is important for overall health, it does not have a direct role in altering blood pH. Magnesium levels are regulated by the kidneys and are essential for maintaining normal muscle and nerve function, but they do not directly influence the acid-base balance.
Choice D: Potassium
Potassium is a key intracellular electrolyte that plays a significant role in maintaining the acid-base balance of the blood. Changes in potassium levels can affect the pH of the blood. For example, hyperkalemia (high potassium levels) can lead to acidosis, while hypokalemia (low potassium levels) can lead to alkalosis. Potassium helps regulate the hydrogen ion concentration in the blood, which directly impacts the pH. Therefore, potassium is the electrolyte most closely associated with changes in blood pH.
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