The nurse is assessing a 13-year-old girl. Which event would the nurse expect to have occurred first?

Choice A: Cardiac complications are not the correct answer because they are not the main cause of the high infant mortality rate. Cardiac complications are problems that affect the heart or blood vessels of the newborn, such as congenital heart defects, arrhythmias, or heart failure. They can cause serious symptoms such as cyanosis, difficulty breathing, or poor feeding. However, they account for only about 5% of all infant deaths in the United States.

Choice B: Necrotizing enterocolitis is the correct answer because it is the main cause of the high infant mortality rate. Necrotizing enterocolitis is a condition that causes inflammation and death of the intestinal tissue of the newborn, leading to infection, perforation, or sepsis. It can cause symptoms such as abdominal distension, bloody stools, or shock. It is more common in premature or low birth weight infants and accounts for about 10% of all neonatal deaths.

Choice C: Viral infections are not the correct answer because they are not the main cause of the high infant mortality rate. Viral infections are diseases that are caused by viruses that invade the cells of the newborn, such as respiratory syncytial virus (RSV), cytomegalovirus (CMV), or herpes simplex virus (HSV). They can cause symptoms such as fever, cough, rash, or blisters. However, they account for only about 2% of all infant deaths in the United States.

Choice D: Prematurity is the correct answer because it is the main cause of the high infant mortality rate. Prematurity is a condition that occurs when a baby is born before 37 weeks of gestation, which is considered full-term. Premature babies are at risk of developing various complications such as respiratory distress syndrome, intraventricular hemorrhage, or retinopathy of prematurity. Prematurity accounts for about 35% of all infant deaths in the United States.

Choice E: Sudden infant death syndrome is the correct answer because it is the main cause of the high infant mortality rate. Sudden infant death syndrome is a condition that causes the unexpected and unexplained death of an apparently healthy baby during sleep. The exact cause of sudden infant death syndrome is unknown, but some risk factors include sleeping on the stomach, overheating, smoking exposure, or soft bedding. Sudden infant death syndrome accounts for about 15% of all infant deaths in the United States.

Choice F: Low birth weight is the correct answer because it is the main cause of the high infant mortality rate. Low birth weight is a condition that occurs when a baby is born weighing less than 2,500 grams (5 pounds 8 ounces). Low birth weight babies are at risk of developing various complications such as hypothermia, hypoglycemia, or jaundice. Low birth weight accounts for about 25% of all infant deaths in the United States.

Choice A: Vaginal intercourse can be resumed after 2 weeks.

Reason: After a dilation and curettage (D&C) procedure, it is generally recommended to avoid vaginal intercourse for about 2 weeks. This allows the cervix and uterus to heal and reduces the risk of infection. Engaging in sexual activity too soon can introduce bacteria into the uterus, which is particularly vulnerable following the procedure.

Choice B: Products of conception will be present in vaginal bleeding.

Reason: This statement is incorrect. After a D&C, the products of conception should have been removed during the procedure. While some bleeding is normal, it should not contain products of conception. Instead, the bleeding should be similar to a menstrual period.

Choice C: Increased intake of zinc-rich foods is recommended.

Reason: There is no specific recommendation for increasing zinc intake following a D&C. The focus is typically on general post-operative care, such as rest, hydration, and monitoring for signs of infection. While a balanced diet is always beneficial, there is no evidence suggesting that zinc-rich foods are particularly necessary after this procedure.

Choice D: Aspirin may be taken for cramps.

Reason: This statement is incorrect. Aspirin is generally not recommended for pain relief after a D&C because it can increase the risk of bleeding. Instead, nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen are usually recommended for managing cramps and pain.