Which factors should be considered a contraindication for transcervical chorionic villus sampling?

Correct Answer: D

Rationale: Transcervical chorionic villus sampling (CVS) is a prenatal diagnostic procedure used to detect genetic abnormalities in the fetus. The correct answer, option D, "Positive for group B Streptococcus," is a contraindication for CVS because the procedure carries a risk of ascending infection, which could be exacerbated by the presence of group B Streptococcus. Option A, "Rh-negative mother," is not a contraindication for CVS as Rh status does not directly impact the safety or efficacy of the procedure. Option B, "Gestation less than 15 weeks," is not a strict contraindication but is generally avoided due to the increased risk of limb reduction defects associated with CVS before 10-12 weeks. Option C, "Maternal age younger than 35 years," is not a contraindication as maternal age alone does not affect the safety of CVS. In an educational context, understanding contraindications for procedures like CVS is crucial for healthcare providers involved in prenatal care. It is important to consider not only the procedural aspects but also the individual patient factors that may impact the safety and success of such interventions. This knowledge ensures that appropriate patient selection is made to optimize outcomes and minimize risks in prenatal testing scenarios.

Correct Answer: C

Rationale: Transvaginal ultrasonography in the first trimester is crucial to evaluate the presence and location of the pregnancy. This is essential for confirming intrauterine pregnancy, determining gestational age accurately, and detecting conditions like ectopic pregnancy. A) Multifetal gestation can be identified using transvaginal ultrasonography, but it is not a specific reason for this test in the first trimester. It may be important later in pregnancy for monitoring multiple fetuses. B) Bicornuate uterus is a structural abnormality that may be better visualized through transvaginal ultrasonography, but it is not a primary indication during the first trimester unless there are specific concerns. D) Amniotic fluid volume is typically assessed later in pregnancy and is not a primary reason for transvaginal ultrasonography in the first trimester. Educational context: Understanding the indications for transvaginal ultrasonography in the first trimester is crucial for healthcare providers caring for pregnant individuals. It aids in early identification of potential pregnancy complications and ensures appropriate management.

Correct Answer: B

Rationale: In this scenario, the priority information for the nurse to provide to a 10-week gravid client should be methods to relieve backaches (Option B). Explanation: 1. **Priority in Early Pregnancy**: At 10 weeks of gestation, the client is in the early stages of pregnancy where backaches are a common complaint due to hormonal changes, ligament stretching, and postural adjustments related to the growing uterus. Providing information on managing backaches early can help prevent worsening discomfort as the pregnancy progresses. 2. **Client-Centered Care**: Addressing backaches aligns with client-centered care by addressing a specific concern the client may be experiencing, promoting comfort, and fostering a trusting nurse-client relationship. 3. **Preventive Education**: Educating the client about methods to relieve backaches early on can empower them to make lifestyle adjustments, practice exercises, and use techniques that may alleviate discomfort and potentially prevent more severe back issues later in pregnancy. Why the Other Options are Incorrect: - **A) Pain management during labor**: While important, discussing pain management during labor is more relevant in the later stages of pregnancy or closer to the due date. Addressing immediate concerns like backaches at 10 weeks is more pertinent. - **C) Breastfeeding positions**: Breastfeeding education is crucial but is typically addressed later in pregnancy or postpartum. At 10 weeks, focusing on immediate physical discomforts like backaches is more relevant. - **D) Characteristics of the newborn**: Information about the characteristics of the newborn is important for prenatal education but is not a priority at 10 weeks. Providing comfort and support for the client's current physical discomfort takes precedence. Educational Context: By prioritizing the information on backache relief, the nurse can support the client's well-being, address a common early pregnancy concern, and lay the foundation for ongoing education and support throughout the prenatal period. This approach demonstrates the nurse's commitment to holistic care and proactive health promotion for the client and her developing fetus.

Correct Answer: C

Rationale: The most appropriate response by the nurse in this situation is option C: "It sounds like you’re feeling a little overwhelmed right now." This response shows empathy and acknowledges the client's feelings without making assumptions or providing false reassurances. Option A is incorrect because it dismisses the client's concerns and provides false certainty. Option B is not the best response as it focuses on practical matters rather than addressing the client's emotional state. Option D assumes the involvement of the baby's father, which may not be the case and can be insensitive to single mothers. In an educational context, it's crucial for nurses to respond to clients with empathy and understanding, especially in sensitive situations like unexpected pregnancies. Acknowledging emotions and offering support can help build trust and rapport with clients, leading to better outcomes for both the mother and the baby. It's important for healthcare providers to approach each situation with sensitivity and respect for the individual's unique circumstances.

Correct Answer: C

Rationale: In the context of maternal fetal monitoring, hearing the fetal heartbeat is the option that usually increases the father's interest and involvement in the pregnancy. This moment is often described as powerful and emotionally significant for fathers as it provides a tangible connection to the developing baby. Hearing the heartbeat can evoke feelings of excitement, responsibility, and bonding, prompting fathers to become more engaged and connected with the pregnancy. Attending childbirth education classes (option B) is important for parental preparedness but may not necessarily increase the father's interest more than hearing the fetal heartbeat. Learning the results of the pregnancy test (option A) is an initial step in acknowledging the pregnancy but may not have the same impact on involvement as a direct connection to the developing fetus. Meeting the obstetrician or midwife (option D) is crucial for prenatal care but may not evoke the same level of emotional response as hearing the heartbeat. Educationally, understanding the emotional and psychological aspects of pregnancy for both parents is essential in providing holistic care. By recognizing the significance of moments like hearing the fetal heartbeat, healthcare providers can better support and involve fathers in the pregnancy journey, fostering a sense of partnership and shared responsibility in maternal fetal monitoring.