Which of the following statements should the nurse include in the teaching to the parents of a newborn about the critical congenital heart disease screening?
To perform the test, I will collect a blood sample from your newborn's heel.
The test will be performed when your newborn is between 6 and 12 hours of age.
The test compares the oxygen saturation in your newborn's upper and lower extremities.
It will take 1 to 2 weeks to obtain the results of your newborn's test.
The Correct Answer is C
Choice A reason: Critical congenital heart disease (CCHD) screening uses pulse oximetry, not a heel blood sample. Blood sampling is for metabolic screening, not heart defects. Pulse oximetry measures oxygen saturation non-invasively, detecting shunting or cyanotic defects, aligning with CCHD screening’s focus on circulatory assessment.
Choice B reason: CCHD screening is typically performed at 24-48 hours of age, not 6-12 hours, to ensure stable postnatal circulation. Early testing may yield false positives due to transitional physiology. Pulse oximetry at the correct timing accurately detects critical heart defects, per neonatal screening protocols.
Choice C reason: CCHD screening compares oxygen saturation in the upper (right hand) and lower (foot) extremities using pulse oximetry to detect congenital heart defects causing differential cyanosis. A significant difference indicates potential shunting or ductal-dependent lesions, requiring further evaluation, aligning with the physiological basis of CCHD screening.
Choice D reason: CCHD screening results are immediate via pulse oximetry, not delayed 1-2 weeks. Real-time oxygen saturation readings identify potential heart defects, enabling prompt referral for echocardiography. Delayed results apply to metabolic screening, not CCHD, which relies on instant physiological data, per neonatal diagnostic protocols.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Monitoring blood pressure every 30 minutes is inadequate for hypotension, which requires immediate intervention to restore placental perfusion. Epidural anesthesia can cause sympathetic blockade, reducing vascular tone and blood pressure. Frequent monitoring (every 5-10 minutes) is needed, but this action does not address the acute hypotension affecting fetal oxygenation.
Choice B reason: The knee-chest position is used for specific obstetric emergencies like cord prolapse, not hypotension from epidural anesthesia. It does not improve blood pressure or placental perfusion. Hypotension requires fluid or vasopressor support to restore circulation, as positional changes like knee-chest do not address the underlying sympathetic blockade causing reduced perfusion.
Choice C reason: Administering oxygen at 2 L/min via nasal cannula does not directly correct hypotension, the primary cause of decreased placental perfusion. While oxygen may support fetal oxygenation, it does not restore maternal blood pressure. Fluid boluses or vasopressors are needed to address the epidural-induced vasodilation and ensure adequate placental blood flow.
Choice D reason: A 500 mL lactated Ringer’s bolus corrects epidural-induced hypotension by expanding intravascular volume, restoring blood pressure, and improving placental perfusion. Epidurals cause sympathetic blockade, reducing vascular tone. Fluid administration counteracts this, enhancing cardiac output and uteroplacental blood flow, critical for fetal oxygenation and preventing hypoxia during labor.
Correct Answer is ["B","C","E"]
Explanation
Choice A reason: A newborn weight of 2.948 kg is normal and not a risk factor for postpartum hemorrhage. Large-for-gestational-age infants (>4 kg) increase uterine overdistension, impairing contraction and causing bleeding. This weight does not strain uterine muscle tone, maintaining normal postpartum hemostasis, per obstetric physiology.
Choice B reason: Uterine atony, failure of the uterus to contract post-delivery, is a major cause of postpartum hemorrhage. Ineffective contractions prevent hemostasis at placental separation sites, leading to excessive bleeding. Myometrial fatigue or previous atony increases risk, as poor uterine tone disrupts clotting cascades, necessitating vigilant monitoring and oxytocic intervention.
Choice C reason: Vacuum-assisted delivery increases postpartum hemorrhage risk due to potential uterine or cervical trauma. Instrumentation can cause lacerations or hematomas, disrupting hemostasis. Tissue trauma triggers local bleeding, and prolonged labor may weaken uterine contractions, impairing clot formation at the placental site, per obstetric complication studies.
Choice D reason: History of human papillomavirus (HPV) does not increase postpartum hemorrhage risk, as it affects cervical epithelium, not uterine contractility or hemostasis. HPV is linked to cervical cancer, not obstetric complications. Postpartum bleeding stems from uterine or traumatic factors, making HPV irrelevant to hemorrhage pathophysiology in the postpartum period.
Choice E reason: Labor induction with oxytocin increases postpartum hemorrhage risk, as prolonged exposure may desensitize myometrial receptors, leading to uterine atony. Ineffective contractions post-delivery impair hemostasis at the placental site, causing bleeding. Oxytocin’s effect on uterine muscle tone requires careful monitoring to prevent excessive blood loss, per obstetric pharmacology.
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