A client at 20 weeks' gestation is undergoing a routine ultrasound. What is the primary focus of this examination?

Correct Answer: B

Rationale: In maternal newborn nursing, routine ultrasound examinations play a crucial role in monitoring the health and development of the fetus. The primary focus of an ultrasound at 20 weeks' gestation is to evaluate fetal anatomy and growth. This is the correct answer (B) because at this stage, major structural abnormalities can be detected, such as neural tube defects, heart abnormalities, and abdominal wall defects. It also allows for assessing growth parameters like fetal size, amniotic fluid volume, and placental location, which are essential for determining the well-being of the fetus. Option A, confirming the baby's sex, is not the primary focus of a 20-week ultrasound. While sex determination can be done during this scan, it is not the main reason for the examination and should not be the primary focus. Option C, assessing maternal cervical length, is important but is typically done in the context of evaluating the risk of preterm labor, not during a routine ultrasound at 20 weeks' gestation. Option D, checking for signs of preterm labor, is also not the primary focus of a routine 20-week ultrasound. Signs of preterm labor would involve different assessments such as monitoring uterine activity, cervical changes, and assessing for symptoms like vaginal bleeding or pelvic pressure. Understanding the primary objectives of different prenatal assessments is crucial for providing comprehensive care to pregnant individuals and ensuring the well-being of both the mother and the fetus. By focusing on evaluating fetal anatomy and growth during a 20-week ultrasound, healthcare providers can detect potential issues early, provide appropriate interventions, and support optimal outcomes for both the mother and the baby.

Correct Answer: A

Rationale: In fetal circulation, the correct answer is A) Ductus arteriosus. The ductus arteriosus is a fetal blood vessel that allows blood to bypass the fetal lungs by connecting the pulmonary artery to the aorta. This shunts blood away from the non-functional fetal lungs to ensure oxygenated blood is circulated throughout the body. Option B) Ductus venosus carries oxygenated blood from the placenta to the fetal heart, aiding in bypassing the liver. Option C) Foramen ovale is an opening between the atria of the fetal heart, allowing blood to bypass the pulmonary circulation. Option D) Umbilical vein carries oxygenated blood from the placenta to the fetus. Understanding fetal circulation is crucial in maternal newborn nursing as it impacts fetal oxygenation and overall well-being. Teaching this concept helps prenatal caregivers understand the unique circulatory adaptations in the fetus and recognize any deviations that may require intervention.

Correct Answer: C

Rationale: In the scenario of a client receiving magnesium sulfate for preeclampsia, the finding that indicates magnesium toxicity is a respiratory rate of 10 breaths per minute (Option C). This is due to the fact that magnesium sulfate is a central nervous system depressant and can lead to respiratory depression as a sign of toxicity. A decreased respiratory rate is a critical indicator of magnesium toxicity and requires prompt intervention to prevent further complications such as respiratory arrest. Option A, increased urine output, is not indicative of magnesium toxicity but rather a desired effect of magnesium sulfate which helps to prevent fluid overload and maintain renal function in preeclamptic clients. Option B, deep tendon reflexes +4, is a common finding in clients receiving magnesium sulfate as it is a magnesium antagonist. Hyperactive reflexes are actually a sign of magnesium deficiency rather than toxicity. Option D, a blood pressure of 140/90 mmHg, is within normal range for a pregnant client with preeclampsia and does not specifically indicate magnesium toxicity. Educationally, understanding the signs and symptoms of magnesium toxicity is crucial for nurses caring for clients receiving magnesium sulfate therapy during pregnancy. Recognizing these signs promptly is essential to prevent serious complications and ensure the safety of both the mother and the baby. Regular monitoring and assessment are key components of managing clients on magnesium therapy.

Correct Answer: B

Rationale: In this scenario, option B "I should seek help if I have trouble bonding with my baby" is the correct answer. This statement indicates understanding because it recognizes a key symptom of postpartum depression, which is difficulty bonding with the newborn. Seeking help is crucial in managing postpartum depression and ensuring the well-being of both the mother and the baby. Option A is incorrect because while it is common to experience mood changes postpartum, feeling sad for the first 6 months is not necessarily indicative of postpartum depression. Option C is incorrect as postpartum depression can occur in any mother, regardless of whether it is their first pregnancy or not. Option D is also incorrect as ignoring feelings of hopelessness can exacerbate the situation and delay appropriate treatment. Educationally, it is important for nurses to teach clients about the signs and symptoms of postpartum depression to promote early detection and intervention. By emphasizing the importance of seeking help and providing support, nurses can empower mothers to prioritize their mental health during the postpartum period.

Correct Answer: B

Rationale: In a client receiving magnesium sulfate for preeclampsia, a respiratory rate of 10 breaths per minute indicates respiratory depression, a serious adverse effect of magnesium toxicity. Magnesium sulfate can depress the central nervous system, leading to respiratory depression, which can progress to respiratory arrest if not addressed promptly. Therefore, discontinuing the infusion is crucial to prevent further complications. Option A (urine output of 50 mL/hour) is not a reason to discontinue the infusion as it falls within the expected range for a client receiving magnesium sulfate. Option C (blood pressure of 140/90 mmHg) is also not an immediate concern in the context of preeclampsia management. Option D (deep tendon reflexes +3) is a common finding in clients receiving magnesium sulfate and does not indicate the need to discontinue the infusion unless accompanied by other signs of magnesium toxicity. Educationally, understanding the signs of magnesium toxicity is vital for nurses caring for clients on magnesium sulfate therapy. Respiratory rate monitoring, along with other assessments, is critical to early identification of magnesium toxicity, allowing for prompt intervention to ensure client safety.