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A client, at 6 weeks gestation, arrives at the OB clinic for her initial visit and requests to hear the fetal heartbeat.
What should the nurse include in the teaching regarding cardiac development?

A.

The fetal heartbeat can be heard via Doppler by 4 weeks of pregnancy.

B.

The fetal heartbeat can be heard by external Doppler around 10-12 weeks of pregnancy.

C.

You will first feel your baby move in week 24 of pregnancy.

D.

The heart formation begins in week 5 of pregnancy and we can hear it by Doppler at 6 weeks.

Answer and Explanation

The Correct Answer is B

Choice A rationale

The fetal heartbeat cannot typically be heard via Doppler as early as 4 weeks of pregnancy. At this stage, the heart is still developing, and it is too soon for external detection with a Doppler device.

 

Choice B rationale

The fetal heartbeat is generally detectable by an external Doppler device around 10-12 weeks of pregnancy. This is the period when the heartbeat is strong enough to be picked up by the device.

 

Choice C rationale

Feeling the baby move, known as "quickening," typically occurs around 18-24 weeks of pregnancy, not 6 weeks. This sensation is different from hearing the heartbeat.

 

Choice D rationale

While the heart begins to form around week 5, it is not detectable by Doppler at 6 weeks. The technology does not have the sensitivity to detect such an early heartbeat externally.


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Correct Answer is A

Explanation

Choice A rationale

Acknowledging the client’s feelings provides emotional support and validates her experience. This response opens the door for further discussion and support, which is crucial for emotional well-being.

Choice B rationale

Suggesting future possibilities does not address the client's current emotional state. It may come across as dismissive of her feelings and does not offer the immediate support she needs.

Choice C rationale

While emphasizing the health of the baby is positive, it can also be perceived as dismissive of the client's feelings and her disappointment about the birth experience.

Choice D rationale

Mentioning the resumption of sexual relations shifts the focus away from her emotional needs and can be inappropriate or insensitive in this context, failing to address her disappointment.

Correct Answer is D

Explanation

Choice A rationale

GBS can be transmitted to the baby during both vaginal and cesarean deliveries if the mother is colonized with the bacteria. It is not limited to cesarean sections, hence why appropriate screening and treatment are essential.

Choice B rationale

GBS, although often harmless in the general population, can cause severe infections in newborns. This bacterium can be a source of severe neonatal infections like sepsis, pneumonia, and meningitis, necessitating preventive measures during pregnancy and delivery.

Choice C rationale

Screening for GBS is typically performed between 35 and 37 weeks of gestation, not at the first prenatal visit. This timing ensures accurate detection of the bacteria closer to the time of delivery.

Choice D rationale

Intravenous antibiotics during labor are recommended for mothers who test positive for GBS to prevent transmission to the baby. This intervention significantly reduces the risk of neonatal GBS infection.

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