The patient at 24 weeks' gestation is experiencing painless ...

[RRMR]

The patient at 24 weeks' gestation is experiencing painless vaginal bleeding after intercourse. The physician has ordered a transvaginal ultrasound examination.
 
  Which statements by the patient indicate an understanding of why this exam has been requested? This ultrasound: (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Will show the baby's gender.
  2. Might cause the miscarriage of my baby.
  3. Carries a risk of creating a uterine infection.
  4. Can determine the location of my placenta.
  5. Might detect whether the placenta is detaching prematurely.

Question 2

The parents of a newborn male ask the nurse whether they should circumcise their son. The best response by the nurse is Circumcision:
 
  1. Should be undertaken to prevent problems in the future.
  2. Might decrease the child's risk of developing a urinary tract infection.
  3. Can sometimes cause complications. What questions do you have?
  4. Is painful, and should be avoided unless you are Jewish.

[wilsonbho]

Answer to Question 1

4,5
Rationale 1: Although gender can sometimes be detected with second-trimester ultrasound, that is never the primary reason for the procedure.
Rationale 2: Ultrasound is non-invasive, and does not increase the risk for either fetal loss or uterine infection.
Rationale 3: Ultrasound is non-invasive, and does not increase the risk for either fetal loss or uterine infection.
Rationale 4: Painless bleeding in the second and third trimesters can be a symptom of placenta previa, or the placenta covering the cervix. Transvaginal ultrasound will determine the placental location.
Rationale 5: Painless bleeding in the second and third trimesters can be symptoms of placenta previa, or the placenta covering the cervix. Transvaginal ultrasound will determine the placental location.

Answer to Question 2

3
Rationale 1: Although this is a common reason parents give for requesting circumcision, it is still an opinion not based in medical fact.
Rationale 2: Although this is a true statement, getting more information from the parents about their questions or concerns would be better.
Rationale 3: Asking this question allows the nurse to determine what the parents' concerns are, then address them specifically.
Rationale 4: Although circumcision can be painful, most providers administer a penile nerve root block to prevent or minimize procedural pain. Circumcision is practiced in many religions and traditions.