While bottle feeding a newborn infant, the nurse demonstrates the proper technique by including which of the following?

The scenario requires understanding maternal psychological adaptation during the first trimester. Knowledge of developmental tasks, specifically the concept of ambivalence and typical emotional fluctuations, is necessary to differentiate between expected emotional responses and physiological complications such as preterm labor signs.

Choice A rationale

While positive anticipation occurs, it is more characteristic of the second trimester when the fetus becomes a tangible entity through quickening. In the first trimester, the focus is primarily on the physical changes occurring within the mothers own body.

Choice B rationale

Increased progesterone levels and metabolic changes during the early stages of pregnancy often result in significant fatigue and somnolence. It is expected for a client to feel a diminished capacity for normal daily activities during this initial period.

Choice C rationale

Introversion and focusing on the fetus typically intensify during the second trimester as the mother incorporates the baby into her image. In the first trimester, extreme preoccupation and singing to the bump are less common responses.

Choice D rationale

Ambivalence is a universal and expected finding in the first trimester, regardless of whether the pregnancy was planned. The client often feels unprepared and has conflicting feelings about the life changes and responsibilities that lie ahead.

Choice E rationale

Regular contractions every five minutes are not an expected finding and may indicate a spontaneous abortion or other complications. Normal physiological changes in the first trimester do not include frequent, rhythmic uterine contractions that require clinical intervention.

This scenario requires understanding Rh incompatibility and passive immunity provided by RhoGAM. Nurses must apply knowledge of maternal antibody production prevention and the timing of prophylactic administration based on neonatal Rh status to ensure the safety of subsequent pregnancies for Rh negative mothers.

Choice A rationale

RhoGAM provides temporary passive immunity, lasting roughly 12 weeks. However, stating it only works for this duration oversimplifies the postpartum requirement. Postpartum administration depends specifically on the neonate being Rh positive to prevent maternal sensitization.

Choice B rationale

One dose is insufficient for total protection during and after pregnancy. Sensitization can occur during delivery when fetal and maternal blood mix. Subsequent doses are necessary after potential exposure events to ensure continued suppression of antibody formation.

Choice C rationale

Amniocentesis is an invasive procedure carries risks and is not used solely for routine blood typing. Neonatal blood type is safely determined using umbilical cord blood after birth, guiding the necessity of the 72 hour postpartum RhoGAM injection.

Choice D rationale

If the neonate is Rh positive, the mother needs a second dose within 72 hours of birth. This prevents the mother from developing permanent antibodies against Rh positive cells, which could jeopardize future pregnancies with Rh positive fetuses.