A primigravida with a history of no prenatal care delivers a normal neonate by sterile vaginal delivery with no complications. The practical nurse (PN) enters the room with an injection of Rho immune globulin and explains the rationale for the injection.
Which situation warrants this injection?

Choice A rationale

Giving prescribed digoxin and furosemide is part of the long-term management for cardiac conditions, but these medications do not provide immediate relief for an acute hypoxic spell. Digoxin improves cardiac contractility, and furosemide promotes fluid excretion, but their onset of action is not rapid enough for emergent situations.

Choice B rationale

Returning the child to bed and elevating the head of the bed might provide some comfort but does not directly address the underlying physiological cause of the hypoxic spell. Elevating the head of the bed may slightly improve respiratory effort but won't reverse cyanosis effectively.

Choice C rationale

Offering to play a board game with the child as a distraction does not address the physiological emergency of a hypoxic spell. Distraction may be helpful for anxiety but is not an intervention for cyanosis, tachypnea, and tachycardia, which require medical intervention.

Choice D rationale

Providing oxygen increases the available oxygen for gas exchange, and promoting the knee-chest position reduces venous return to the heart, thereby decreasing right-to-left shunting and improving pulmonary blood flow in conditions like Tetralogy of Fallot, which commonly presents with "squatting" and hypoxic spells.

Choice A rationale

Emptying the bladder prior to amniocentesis reduces the risk of bladder puncture during the procedure. A full bladder could also displace the uterus, making needle insertion more challenging and increasing the potential for complications. This anatomical consideration ensures a safer and more accurate procedure for both mother and fetus.

Choice B rationale

Refraining from sexual intercourse for 48 hours prior to the procedure is not a standard or necessary instruction for an amniocentesis. While pelvic rest might be advised in certain high-risk pregnancies or after procedures that could compromise cervical integrity, it is not a general prerequisite for this diagnostic test.

Choice C rationale

Showering with an antibacterial soap the night before the procedure is a general hygienic practice but is not specifically required for an amniocentesis. While aseptic technique is paramount during the procedure itself, a special antibacterial shower beforehand is not a standard protocol to prevent infection in this context.

Choice D rationale

Taking an enema the morning of the procedure is not indicated for an amniocentesis. Enemas are typically used to clear the bowel for gastrointestinal procedures or to relieve constipation. There is no physiological or procedural benefit to bowel evacuation prior to an amniocentesis.