A mother has a child who is 4 years of age, and she is expecting another child.The mother expresses concern to the nurse about how the older sibling will receive the newborn.Which intervention shared by the mother would require follow-up by the nurse?
“I plan to let him hear the baby’s heartbeat at the next prenatal visit.”.
“I have enrolled him in a sibling preparation class at the hospital.”.
“I think that I will just bring the new baby home as a surprise.”.
“I let him pick out a gift for the baby, and have one for him from the baby.”.
The Correct Answer is C
Choice A rationale
Allowing the older sibling to hear the baby’s heartbeat at a prenatal visit can help them feel involved and connected to the new baby. This can be a positive experience and does not require follow-up by the nurse.
Choice B rationale
Enrolling the older sibling in a sibling preparation class at the hospital is a good way to prepare them for the arrival of the new baby. These classes often provide valuable information and help older siblings understand what to expect.
Choice C rationale
Bringing the new baby home as a surprise can be problematic. It may cause the older sibling to feel excluded or unprepared for the new addition to the family. It is important to involve the older sibling in the process and prepare them for the changes that will come with the new baby.
Choice D rationale
Allowing the older sibling to pick out a gift for the baby and having a gift for them from the baby can help foster a positive relationship between the siblings. This approach can make the older sibling feel valued and included.
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Correct Answer is A
Explanation
Choice A rationale
The uterus can indeed increase in size by 20 times its non-pregnant size. This significant expansion is necessary to accommodate the growing fetus and the increased blood supply required during pregnancy.
Choice B rationale
While the weight of the uterus does increase significantly during pregnancy, from about 100 grams to approximately 1,000 grams, this statement does not directly address the client’s concern about the uterus’s ability to stretch.
Choice C rationale
About 25% of the increased capacity of the uterus is related to uteroplacental content, but this does not fully explain the uterus’s ability to stretch to accommodate a full-term baby.
Choice D rationale
The increase in uterus size during pregnancy is not solely related to amniotic fluid volume. The uterus itself grows and stretches significantly to accommodate the developing fetus.
Correct Answer is C
Explanation
Choice A rationale
A blood transfusion just after delivery is not a standard intervention for a client with Rh-negative blood type. The primary concern for Rh-negative clients is the potential for Rh incompatibility with the fetus, which can lead to hemolytic disease of the newborn. This condition is prevented by administering RhO(D) immune globulin during pregnancy.
Choice B rationale
Maternal serum alpha-fetoprotein (MSAFP) testing is used to screen for certain fetal abnormalities, such as neural tube defects, but it is not specifically related to Rh incompatibility. The primary intervention for Rh-negative clients is the administration of RhO(D) immune globulin to prevent sensitization.
Choice C rationale
RhO(D) immune globulin is administered at around 28 weeks of gestation to prevent Rh sensitization in Rh-negative clients. This intervention is crucial for preventing the development of antibodies that could harm the fetus in current or future pregnancies.
Choice D rationale
A three-hour glucose tolerance test is used to screen for gestational diabetes, which is a separate concern from Rh incompatibility. The primary intervention for Rh-negative clients is the administration of RhO(D) immune globulin.