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?
The fetal heartbeat can be heard via Doppler by 4 weeks of pregnancy.
The fetal heartbeat can be heard by external Doppler around 10-12 weeks of pregnancy.
You will first feel your baby move in week 24 of pregnancy.
The heart formation begins in week 5 of pregnancy and we can hear it by Doppler at 6 weeks.
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
Uteroplacental insufficiency leads to late decelerations, which are characterized by a gradual decrease in fetal heart rate after the peak of a contraction. This indicates compromised blood flow between the uterus and placenta, affecting the fetus.
Choice B rationale
Umbilical cord compression usually causes variable decelerations, not late decelerations.
Choice C rationale
Maternal bradycardia does not cause changes in fetal heart rate patterns like late decelerations.
Choice D rationale
Fetal head compression causes early decelerations, which coincide with contractions, not late decelerations.
Correct Answer is B
Explanation
Choice A rationale
Monitoring the newborn's blood pressure does not directly address symptoms like diaphoresis, jitteriness, and lethargy. These symptoms indicate an immediate need to check blood glucose levels for hypoglycemia.
Choice B rationale
Obtaining blood glucose by heel stick is the correct step because diaphoresis, jitteriness, and lethargy in a newborn are classic signs of hypoglycemia. Timely detection and correction of blood glucose levels are critical.
Choice C rationale
Placing the newborn in a radiant warmer might help maintain body temperature but does not address the root cause of the symptoms, which is likely hypoglycemia.
Choice D rationale
Initiating phototherapy is used to treat jaundice (high bilirubin levels) and is not indicated for managing symptoms of hypoglycemia like diaphoresis, jitteriness, and lethargy.