A nurse in labor and delivery is caring for a client who has just delivered a healthy baby boy.Following delivery of the placenta, the nurse examines the umbilical cord.Which of the following vessels should the nurse expect to observe in the umbilical cord?
One artery and one vein.
Two veins and one artery.
Two arteries and one vein.
Two arteries and two veins.
The Correct Answer is C
Choice A rationale
The umbilical cord does not typically contain one artery and one vein. This configuration would not provide the necessary blood flow to support fetal development. The umbilical cord must have two arteries to carry deoxygenated blood and waste products from the fetus to the placenta, and one vein to carry oxygenated blood and nutrients from the placenta to the fetus.
Choice B rationale
Two veins and one artery is also incorrect. The umbilical cord must have two arteries to ensure that deoxygenated blood and waste products are efficiently transported from the fetus to the placenta. Having only one artery would not suffice for the required blood flow.
Choice C rationale
Two arteries and one vein is the correct configuration of the umbilical cord. The two arteries carry deoxygenated blood and waste products from the fetus to the placenta, while the single vein carries oxygenated blood and nutrients from the placenta to the fetus. This arrangement is essential for maintaining proper fetal circulation during pregnancy.
Choice D rationale
Two arteries and two veins is incorrect. The umbilical cord only needs one vein to carry oxygenated blood and nutrients from the placenta to the fetus. Having two veins would be redundant and unnecessary for fetal development.
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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.
Correct Answer is C
Explanation
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.