The nurse sees a woman for the first time when she is 30 weeks pregnant. The client has smoked throughout the pregnancy, and fundal height measurements now are suggestive of intrauterine growth restriction (IUGR) in the fetus. In addition to ultrasound to measure fetal size, what is another tool useful in evaluating this condition?
Doppler blood flow analysis
Non stress test (NST)
Daily fetal movement counts
Amniocentesis
The Correct Answer is A
A. Doppler studies of the umbilical artery and other fetal vessels assess placental blood flow and fetal perfusion, which is particularly useful in cases of suspected IUGR. Abnormal Doppler readings, such as absent or reversed end-diastolic flow, indicate compromised placental function and increased fetal risk, guiding management decisions regarding timing of delivery and close surveillance.
B. While NSTs monitor fetal heart rate reactivity and overall fetal well-being, they do not directly assess placental blood flow or fetal growth restriction. NSTs are useful for ongoing fetal surveillance but are secondary in evaluating the etiology of IUGR.
C. These are important for monitoring fetal well-being, especially in high-risk pregnancies, but they cannot quantify growth or assess placental insufficiency. Movement counts are more of a screening tool rather than a diagnostic method for IUGR.
D. This procedure is typically used for genetic testing, fetal lung maturity, or assessment of certain infections, but it does not provide information about fetal size or placental blood flow. It is not a primary tool for evaluating IUGR.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Nalbuphine is an opioid agonist-antagonist used for maternal pain relief. It does not reverse opioid effects in the neonate and therefore cannot be used to counteract neonatal respiratory depression caused by butorphanol.
B. Fentanyl is a potent opioid analgesic, not a reversal agent. Administering fentanyl to a neonate would increase opioid effects, potentially worsening respiratory depression, rather than mitigating it.
C. Naloxone is an opioid antagonist that rapidly reverses the effects of opioids such as butorphanol, including respiratory depression, sedation, and decreased muscle tone in the neonate. It can be administered to the neonate immediately after birth if there are signs of opioid-induced depression, such as low Apgar score, poor respiratory effort, or decreased reflexes. The nurse should have naloxone readily available when opioids are administered near delivery.
D. Promethazine is an antihistamine with antiemetic and sedative properties. It has no effect on opioid-induced respiratory depression and is not appropriate for reversing butorphanol effects in the neonate.
Correct Answer is C
Explanation
A. Detection of a fetal heartbeat by ultrasound is a positive sign of pregnancy because it provides direct, objective evidence of a living fetus. Positive signs can only be attributed to pregnancy and include fetal heart tones, visualization of the fetus, and fetal movements palpated by the examiner.
B. A positive pregnancy test is a probable sign of pregnancy. It detects human chorionic gonadotropin (hCG) in blood or urine, which is usually produced during pregnancy, but false positives can occur due to hCG-secreting tumors, recent pregnancy loss, or fertility medications.
C. Breast tenderness and enlargement are presumptive signs of pregnancy. Presumptive signs are subjective symptoms reported by the woman and are not diagnostic. They result from early hormonal changes (increased estrogen and progesterone) and may also occur with premenstrual syndrome or hormonal imbalances, making them non-specific to pregnancy.
D. Abdominal enlargement is a probable sign of pregnancy because it is an objective finding observed by the healthcare provider but can be caused by other conditions such as obesity, uterine fibroids, ovarian tumors, or ascites.
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