A woman who is 24 weeks pregnant is placed on an intravenous infusion of magnesium sulfate.
What side effect should the nurse inform the patient that she might experience?

Choice A rationale

A Simian crease, or single palmar transverse crease, is a characteristic dermatoglyphic feature found in approximately 50.

Choice B rationale

Individuals with Down syndrome often exhibit clinodactyly, specifically the inward curvature of the fifth (pinky) finger. This is often accompanied by a single flexion crease instead of the typical two on the small finger, making the fingers appear curved and smaller. These skeletal anomalies are common manifestations of the genetic disorder's effect on bone development.

Choice C rationale

Delayed and irregular eruption of teeth is common in Down syndrome. However, the front teeth (incisors) are often smaller (microdontia) and spaced far apart (diastema), not typically wide-spaced front teeth in the sense of a prominent gap, which is not a primary characteristic. The palate is frequently narrow and high-arched, which contributes to dental irregularities.

Choice D rationale

A protruding tongue (macroglossia) is a frequent physical characteristic in Down syndrome, resulting from a combination of a relatively small oral cavity, hypotonia (low muscle tone) of the facial and tongue muscles, and an objectively large tongue. This feature contributes to feeding difficulties and articulation challenges, and is a notable manifestation of the disorder.

Choice E rationale

The eyes in Down syndrome are typically characterized by upward slanting palpebral fissures, epicanthal folds (skin folds at the inner corner of the eyes), and small white spots on the iris (Brushfield spots). The eyes are usually closely set (hypotelorism) or appear so due to the facial structure, rather than being loose-set (widely spaced), which is characteristic of other syndromes.

Choice A rationale

Cystic fibrosis is an autosomal recessive genetic disorder caused by a mutation in the CFTR gene, affecting chloride transport and leading to production of abnormally thick mucus, primarily impacting the respiratory and digestive systems. It is a chronic condition and not an acute condition occurring immediately at birth requiring immediate surfactant administration through an endotracheal tube.

Choice B rationale

Bronchopulmonary dysplasia (BPD), sometimes referred to as chronic lung disease, is a long-term respiratory complication, mainly affecting premature infants who required prolonged mechanical ventilation and oxygen. It is characterized by abnormal lung development and fibrosis. While it is linked to prematurity, it is a chronic sequel, not the immediate neonatal condition that necessitates the initial surfactant intervention.

Choice C rationale

A pneumothorax is the presence of air in the pleural space, which collapses the lung and leads to acute respiratory distress. While it can occur in preterm infants, especially those on mechanical ventilation, it is a mechanical complication requiring a chest tube for air aspiration, not a condition caused by primary surfactant deficiency that is treated with exogenous surfactant administration.

Choice D rationale

Respiratory Distress Syndrome (RDS), historically called Hyaline Membrane Disease, is the leading cause of morbidity in premature infants. It results from a developmental deficiency of pulmonary surfactant, a lipoprotein that lowers alveolar surface tension. This deficiency causes widespread alveolar collapse (atelectasis) and decreased lung compliance, necessitating immediate exogenous surfactant replacement via the endotracheal tube to improve lung function.