A woman is recovering at the gynecologist's office following a first trimester spontaneous abortion. At this time, it is essential for the nurse to check which of the following?
Maternal blood type
Past obstetric history
Maternal varicella titer
Cervical patency
The Correct Answer is A
Choice A) Maternal blood type is correct because this is an essential and relevant information for the nurse to check for a woman who has had a first trimester spontaneous abortion. Spontaneous abortion, also known as miscarriage, is the loss of pregnancy before 20 weeks of gestation. It can be caused by various factors such as chromosomal abnormalities, infections, trauma, or hormonal imbalances. Maternal blood type is the classification of blood based on the presence or absence of antigens and antibodies on the red blood cells and plasma. The most common blood types are A, B, AB, and O, and each can be positive or negative for the Rh factor. Checking maternal blood type can help to identify and prevent Rh incompatibility, which is a condition that occurs when the mother has Rh-negative blood and the fetus has Rh-positive blood. This can cause the mother's immune system to produce antibodies that attack the fetal red blood cells, leading to hemolytic disease of the fetus and newborn (HDFN), which can cause anemia, jaundice, or death. To prevent this, the nurse should administer Rh immunoglobulin (RhoGAM) to the mother within 72 hours after a spontaneous abortion or any event that may cause mixing of maternal and fetal blood. Therefore, this information is vital and appropriate for the nurse to check.
Choice B) Past obstetric history is incorrect because this is not an essential or urgent information for the nurse to check for a woman who has had a first trimester spontaneous abortion. Past obstetric history is the record of previous pregnancies and their outcomes, such as number, duration, complications, or interventions. It can provide useful information for assessing the risk factors and health status of the current pregnancy. However, it does not have any immediate impact or implication for the management of a spontaneous abortion, which is a common and unpredictable event that affects about 10% to 20% of all pregnancies. Therefore, this information can be obtained later or from other sources by the nurse.
Choice C) Maternal varicella titer is incorrect because this is not a relevant or necessary information for the nurse to check for a woman who has had a first trimester spontaneous abortion. Varicella titer is a blood test that measures the level of antibodies against varicella-zoster virus (VZV), which causes chickenpox and shingles. It can indicate whether a person has immunity to VZV or needs vaccination. Checking maternal varicella titer may be important for pregnant women who have not had chickenpox or vaccination before, as VZV infection during pregnancy can cause congenital varicella syndrome (CVS), which can affect the development and function of various organs in the fetus. However, it does not relate to spontaneous abortion, which is not caused by VZV infection or immunity. Therefore, this information is irrelevant and unnecessary for the nurse to check.
Choice D) Cervical patency is incorrect because this is not a reliable or accurate information for the nurse to check for a woman who has had a first trimester spontaneous abortion. Cervical patency means how open or closed the cervix is, which can affect the progress and outcome of labor and delivery. The cervix is usually closed and firm during pregnancy, but it gradually softens, shortens, and dilates as labor approaches. Checking cervical patency can help to determine if labor has started or if there are any complications such as preterm labor or cervical incompetence.
However, it does not indicate if a spontaneous abortion has occurred or not, as the cervix may remain closed or partially open after a miscarriage. Moreover, checking cervical patency can be invasive and uncomfortable for the woman who has had a spontaneous abortion, and it may increase the risk of infection or bleeding. Therefore, this information should be checked only when indicated by the physician and with caution by the nurse.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A) Increased urinary output: This is not a sign of sepsis in newborns. In fact, sepsis can cause reduced urinary output due to poor blood flow to the kidneys and dehydration.
Choice B) Hypothermia: This is a sign of sepsis in newborns. Sepsis can cause changes in temperature, often fever, but sometimes low temperature. Hypothermia can indicate a severe infection that affects the body's ability to regulate its temperature.
Choice C) Wakefulness: This is not a sign of sepsis in newborns. Sepsis can cause reduced activity and lethargy due to inflammation and organ dysfunction.
Choice D) Interest in feeding: This is not a sign of sepsis in newborns. Sepsis can cause reduced sucking and difficulty feeding due to poor appetite, nausea, vomiting, and abdominal distension.
Correct Answer is D
Explanation
Choice a) They are born before 38 weeks of gestation is incorrect because this is not the definition of SGA. SGA refers to newborns who have a birth weight or length that is significantly lower than expected for their gestational age, regardless of when they are born. Therefore, a newborn can be SGA even if they are born at term or post-term.
Choice b) Placental malfunction is the only recognized cause of this condition is incorrect because this is not the only factor that can contribute to SGA. Placental malfunction can cause fetal growth restriction due to insufficient blood supply and nutrients to the fetus, but there are other possible causes such as maternal factors (e.g.,
hypertension, diabetes, smoking, malnutrition), fetal factors (e.g., chromosomal abnormalities, infections, congenital anomalies), and environmental factors (e.g., altitude, pollution, stress).
Choice c) They weigh less than 2500 g is incorrect because this is not the criterion for SGA. SGA is based on the comparison of the newborn's weight or length with the expected values for their gestational age, not on an absolute cutoff. Therefore, a newborn can be SGA even if they weigh more than 2500 g, as long as they are below the 10th percentile for their gestational age.
Choice d) They are below the 10th percentile on gestational growth charts is correct because this is the most commonly used definition of SGA. Gestational growth charts are tools that plot the expected weight or length of a fetus or newborn according to their gestational age and sex. They are based on population data and can vary
depending on the ethnicity and region of origin of the mother and the baby. A newborn who falls below the 10th percentile on these charts is considered SGA, meaning that they have grown less than 90% of their peers .
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