A nurse is answering Questions about labor and delivery to a client.The client is concerned that she will need a blood transfusion due to all the blood loss during the delivery.The nurse explains that blood volume increases during pregnancy that will offset the loss.Which of the following is the correct percentage of increased blood volume during pregnancy that the nurse should explain to the client?
25%-35%.
10%-20%.
60%-70%.
40%-50%.
The Correct Answer is D
Choice A rationale
A 25%-35% increase in blood volume is lower than the actual increase observed during pregnancy. This choice is incorrect.
Choice B rationale
A 10%-20% increase in blood volume is significantly lower than the actual increase observed during pregnancy. This choice is incorrect.
Choice C rationale
A 60%-70% increase in blood volume is higher than the actual increase observed during pregnancy. This choice is incorrect.
Choice D rationale
The correct percentage of increased blood volume during pregnancy is 40%-50%. This increase helps accommodate the growing fetus and placenta, and prepares the body for the blood loss that occurs during delivery.
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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 B
Explanation
Choice A rationale
Not providing resources immediately may leave the patient feeling unsupported and isolated. It is important to offer resources and support to help the patient cope with the emotional and psychological impact of terminating a pregnancy due to a genetic abnormality.
Choice B rationale
Discussing the stages of grief is an appropriate nursing action. It helps the patient understand that their feelings are normal and provides a framework for processing their emotions. This support can be crucial in helping the patient navigate their grief and begin the healing process.
Choice C rationale
Encouraging the patient to rethink their decision is not appropriate. The decision to terminate a pregnancy due to a genetic abnormality is often difficult and deeply personal. It is important to respect the patient’s decision and provide support rather than questioning their choice.
Choice D rationale
Encouraging the couple not to share their emotions with each other can be harmful. Open communication between partners is essential for mutual support and understanding during such a challenging time. Encouraging them to share their feelings can strengthen their relationship and help them cope with the loss together.