The nurse takes the history of a client, G2 P1001, at her first prenatal visit. Which of the following statements would indicate that the client should be referred to a genetic counselor?

Correct Answer: D

Rationale: The correct answer is D) My first child has cystic fibrosis. This statement indicates a potential genetic component that may increase the risk of cystic fibrosis in subsequent children. Referring the client to a genetic counselor is important to assess the risk, provide genetic counseling, and discuss possible screening options. Option A) My first child has cerebral palsy, option B) My first child has hypertension, and option C) My first child has asthma do not directly indicate a need for genetic counseling. Cerebral palsy, hypertension, and asthma are not typically genetic conditions that would necessitate a referral to a genetic counselor. In an educational context, understanding when to refer a client to a genetic counselor is crucial for nurses providing prenatal care. Genetic counselors play a key role in assessing genetic risks, offering support, and facilitating informed decision-making for families. Identifying red flags in a family history, such as a child with cystic fibrosis, highlights the importance of genetic counseling to support the health and well-being of the mother and her potential future children.

Correct Answer: A

Rationale: In the context of maternal monitoring during labor, the nurse should highlight the vital sign changes of the pregnant woman to the obstetrician to ensure the well-being of both the mother and the fetus. Option A is the correct choice as it indicates a significant increase in blood pressure from the prepregnancy state to the third trimester, which could be indicative of gestational hypertension or preeclampsia, conditions that require immediate medical attention. Option B, respiratory rate changes, are not typically a primary concern in maternal monitoring unless there are specific respiratory issues present. Option C, heart rate changes, can be expected to increase slightly during pregnancy due to the physiological changes but are not as critical as blood pressure changes. Option D, temperature changes, are not typically a key indicator of complications during labor unless there are signs of infection. Educationally, understanding the significance of vital sign changes during pregnancy is crucial for nurses to detect and address potential complications promptly. By emphasizing the importance of continuous monitoring and timely reporting of vital sign changes, nurses can contribute to ensuring the safety and well-being of both the mother and the baby during labor and delivery.

Correct Answer: B

Rationale: In the context of maternal monitoring during labor, the correct position for a 31-week gestation client to lie on the examining table during a prenatal examination is the lateral-recumbent position (Option B). This position is suitable for pregnant women as it helps to relieve pressure on the vena cava, promoting better blood flow to the placenta and reducing the risk of supine hypotensive syndrome. Option A, Orthopneic position, is not suitable for a pregnant woman during a prenatal examination as it can cause discomfort and may not provide the needed support for the client's body. Option C, Sims' position, is used for rectal examinations and not appropriate for prenatal examinations. Option D, Semi-Fowler’s position, is commonly used for patients experiencing respiratory distress or for postoperative care but is not the ideal position for a prenatal examination in a 31-week gestation client. Educationally, it is essential for nurses and healthcare providers to understand the importance of positioning pregnant clients correctly during prenatal examinations to ensure the safety and well-being of both the mother and the fetus. By selecting the lateral-recumbent position, healthcare providers can optimize maternal comfort and circulation during the examination, ultimately contributing to better outcomes for both the mother and the baby.

Correct Answer: B

Rationale: In the context of maternal monitoring during labor, the correct answer is B) Rise in white blood cells from 5,000 cells/mm3 to 15,000 cells/mm3. This change indicates an increase in white blood cells, which is a normal physiological response during pregnancy due to the body's preparation for potential postpartum hemorrhage. Option A) Rise in hematocrit from 34% to 38% is not a typical finding during pregnancy, as hematocrit levels tend to decrease slightly due to hemodilution. Option C) Rise in potassium from 3.9 mEq/L to 5.2 mEq/L could indicate a potential issue like renal dysfunction, but it is not a common finding solely related to pregnancy. Option D) Rise in sodium from 137 mEq/L to 150 mEq/L is not a typical change during pregnancy and could indicate dehydration or other underlying conditions. Educationally, understanding the normal physiological changes in laboratory values during pregnancy is crucial for healthcare providers caring for pregnant women. Monitoring these values helps in early detection of any abnormalities and ensures appropriate interventions are implemented promptly to safeguard the health of both the mother and the fetus.

Correct Answer: A

Rationale: The correct answer is A) Stay out of any rooms that are being renovated. This advice is critical because the woman and her unborn child could be exposed to potentially harmful substances during the renovation process, such as lead paint or asbestos, which were commonly used in homes built in the 1930s. These substances can pose serious health risks to the developing fetus. Option B) Drink water only from the hot water tap is incorrect because it does not address the specific risk associated with renovating an older home. Option C) Refrain from entering the basement is also incorrect as it does not specifically address the potential dangers of exposure to renovation materials. Option D) Climb the stairs only once per day is unrelated to the scenario presented and does not provide any protection from the hazards of renovation. In an educational context, it is essential for healthcare providers to counsel pregnant women on potential environmental hazards that could impact their health and the health of their unborn child. This scenario highlights the importance of being aware of the risks associated with living in older homes and undergoing renovations during pregnancy to ensure the safety and well-being of both the mother and the baby.