Which of the following statements should a nurse make when discussing the plan of care with a client at a 10-week prenatal visit diagnosed with a missed spontaneous abortion confirmed by ultrasound?
It can be helpful to talk about your loss with others who have experienced a pregnancy loss.
I have found that it is best to avoid seeing the fetal remains after the procedure.
It is okay to feel some grief now, even though it is so early in the pregnancy for a loss.
Once the fetus is passed, the provider will likely be able to determine what caused the pregnancy loss.
The Correct Answer is A
Choice A reason: Discussing pregnancy loss with others who have experienced it provides emotional support, reducing feelings of isolation. Grief triggers stress hormones like cortisol, which can affect mental health. Peer support normalizes emotional responses, aiding psychological recovery by fostering shared understanding and coping strategies, validated by psychosocial research in miscarriage care.
Choice B reason: Advising against seeing fetal remains is inappropriate, as it may dismiss the client’s emotional needs. Grief processing varies, and viewing remains can aid closure for some. This statement imposes a personal bias, ignoring individual psychological responses to loss, which are influenced by complex neuroendocrine and emotional pathways.
Choice C reason: While acknowledging grief is valid, stating it is okay “even though” it is early minimizes the loss’s impact. Early pregnancy loss can trigger significant grief due to hormonal shifts and attachment. This statement risks invalidating the client’s emotional experience, which is shaped by psychological and neuroendocrine responses to miscarriage.
Choice D reason: Determining the cause of a missed abortion at 10 weeks is often not feasible, as fetal tissue may not yield specific findings. Chromosomal abnormalities, a common cause, require genetic testing, not routine post-procedure analysis. This statement risks false reassurance, as miscarriage etiology is frequently multifactorial and not always identifiable.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Consuming 27 mg of iron daily meets pregnancy requirements, supporting hemoglobin synthesis and preventing anemia. Iron deficiency increases risks of preterm birth or low birth weight, but adequate intake promotes maternal and fetal oxygenation. This level aligns with nutritional guidelines, reducing high-risk pregnancy complications, per hematological studies.
Choice B reason: Consuming 400 mcg of folate daily is recommended to prevent neural tube defects in the fetus. Folate supports DNA synthesis and cell division, critical for early embryonic development. Adequate folate intake reduces congenital anomaly risks, making it a protective factor, not a contributor to high-risk pregnancy, per nutritional science.
Choice C reason: Consuming 300 mg of caffeine daily increases high-risk pregnancy risks, as caffeine crosses the placenta, potentially reducing fetal growth and increasing miscarriage or preterm birth risks. It constricts placental blood vessels, impairing nutrient and oxygen delivery. Studies link excessive caffeine to adverse perinatal outcomes, necessitating moderation to ensure fetal safety.
Choice D reason: Consuming 3 L of water daily supports hydration, critical for amniotic fluid maintenance and maternal circulation in pregnancy. Adequate hydration prevents complications like oligohydramnios or preterm labor. This intake aligns with physiological needs, reducing high-risk pregnancy factors by supporting renal and placental function, per obstetric hydration guidelines.
Correct Answer is D
Explanation
Choice A reason: Early decelerations of the FHR result from head compression during contractions, a benign response reflecting vagal stimulation. They mirror contraction patterns and do not indicate fetal distress. Epidural analgesia may reduce maternal blood pressure, but early decelerations are unrelated to hypoxia, requiring no immediate reporting in this context.
Choice B reason: FHR accelerations of 15 beats/min for 15 seconds indicate fetal well-being, reflecting a responsive autonomic nervous system. They occur with fetal movement or stimulation and are not concerning. Epidural analgesia does not typically cause accelerations, and these findings do not warrant reporting, as they signify normal fetal oxygenation and neurological function.
Choice C reason: An FHR of 150/min is within the normal range (110-160/min) and does not indicate distress. Epidural analgesia may cause maternal hypotension, affecting placental perfusion, but a stable FHR within normal limits reflects adequate fetal oxygenation. This finding does not require immediate reporting, as it aligns with normal fetal physiology.
Choice D reason: Prolonged absent FHR variability suggests fetal compromise, as variability reflects autonomic nervous system function and oxygenation. Epidural analgesia can cause maternal hypotension, reducing placental perfusion and leading to hypoxia, which diminishes variability. This critical finding requires immediate reporting to address potential fetal distress and prevent adverse outcomes like acidosis.
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