During pregnancy, what is the expected change in white blood cell count?

Choice A rationale

Chlamydia trachomatis is a common bacterial sexually transmitted infection. While it can cause complications for the newborn, such as conjunctivitis and pneumonia, it is not considered one of the TORCH infections. The acronym TORCH stands for Toxoplasmosis, Other agents (like syphilis, parvovirus B19, varicella-zoster virus), Rubella, Cytomegalovirus, and Herpes simplex virus. Chlamydia is not part of this specific group of congenital infections, although it is an important cause of neonatal morbidity.

Choice B rationale

Rabies is a viral disease that affects the central nervous system. Transmission to humans typically occurs through the bite of an infected animal. While rabies is a serious and often fatal disease, it is not a component of the TORCH infections. The TORCH infections are a specific group of pathogens known for their ability to cross the placenta and cause congenital malformations and other fetal health issues, a category that does not include rabies.

Choice C rationale

Influenza is a viral respiratory illness. While it can cause serious illness in pregnant women and has been associated with poor pregnancy outcomes, such as preterm birth and low birth weight, it is not one of the designated TORCH infections. The TORCH group specifically includes agents that are known to cause a predictable pattern of congenital anomalies and neonatal diseases following transplacental transmission. Influenza does not typically fall into this category.

Choice D rationale

Varicella Zoster virus (VZV) is the causative agent of both chickenpox and shingles. It is included under the "O" (Other) in the TORCH acronym. If a pregnant woman contracts primary varicella infection, the virus can cross the placenta and cause congenital varicella syndrome. This syndrome can lead to serious congenital anomalies, including limb hypoplasia, neurological abnormalities, and ocular defects, making it a significant threat to the fetus. *.

Choice A rationale

Dismissing a client's concerns, regardless of whether they are a normal finding, can invalidate their feelings and damage the therapeutic relationship. This approach fails to address the client's psychosocial needs, potentially leading to increased stress, anxiety, and non-adherence to care recommendations. Nursing practice emphasizes holistic care, which includes acknowledging and addressing emotional distress to promote psychological well-being. This intervention is not therapeutic or supportive.

Choice B rationale

While it's true that some women's bodies do recover postpartum, explaining this without first addressing the client's current concerns can be dismissive. The client's present body image distress is the immediate issue. Providing information about future outcomes without validating their current feelings can seem unfeeling and may not provide the immediate support needed. The focus should be on the now, not just on a future possibility.

Choice C rationale

Stretch marks, or striae gravidarum, are a result of the stretching of the dermis, the middle layer of skin, due to rapid growth during pregnancy. The integrity of the skin's connective tissue, specifically collagen and elastin fibers, is compromised. Topical lotions are largely ineffective in preventing their formation as the changes occur at a deeper dermal level. Lotions may help with skin hydration and itching, but they do not prevent stretch marks.

Choice D rationale

Acknowledging a client's concerns validates their feelings and establishes a trusting nurse-client relationship. By encouraging sharing, the nurse creates a safe space for the client to express their emotions. This therapeutic communication technique promotes emotional well-being and allows the nurse to assess the severity of the concern and provide individualized, empathetic support. It addresses the psychosocial aspect of care.

Choice E rationale

Referring a client for counseling is an appropriate intervention when their body image concerns are significant, persistent, or causing distress beyond the scope of a typical nursing conversation. Counseling can provide professional support and coping strategies. This intervention demonstrates an understanding that psychosocial issues may require specialized care, and it empowers the client to seek help from a qualified mental health professional. It is a key nursing intervention. *.