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Question

Difficulty: MediumHigh Risk Behaviors

A maternity clinic nurse is conducting an initial prenatal visit for a client at 8 weeks gestation. The client confides, "I usually drink heavily on the weekends, and I had a few episodes of binge drinking before I knew I was pregnant. I am terrified that I have already caused permanent harm to my baby." Which response by the nurse is the most appropriate?

  1. Let us discuss how alcohol impacts fetal development and work together on a plan to help you maintain abstinence during your pregnancy.Answer
  2. B
    Why did you continue to drink alcohol on the weekends if there was a possibility you could be pregnant?
  3. C
    Try not to worry too much; the placenta acts as a barrier and protects the developing baby from most toxins during the first trimester.
  4. D
    We will schedule routine fetal ultrasounds to carefully monitor the baby's growth, which is the best way to prevent any complications.

Answer

The most appropriate response is to discuss the impact of alcohol on fetal development and collaboratively plan for complete abstinence.
The correct response utilizes therapeutic communication by acknowledging the high-risk behavior without judgment, offering factual education regarding fetal development, and establishing a collaborative partnership to achieve the vital goal of alcohol abstinence for the remainder of the pregnancy.

Step-by-Step Solution

1
Analyze the client's statement and emotional state.
The client is expressing severe guilt and fear regarding a high-risk behavior (binge drinking) during the highly sensitive early weeks of pregnancy.
Identifying the client's emotional distress and the clinical risk is necessary to formulate a response that is both therapeutic and clinically sound.
2
Evaluate the communication options based on therapeutic principles.
The correct response must avoid judgment, refrain from providing false reassurance, and directly address the clinical need for behavioral modification.
Therapeutic communication fosters trust and encourages honesty while promoting client safety and optimal health outcomes.
3
Select the most appropriate nursing response.
Choosing the response that offers factual education and a collaborative approach to maintaining abstinence is the best intervention.
This approach directly addresses the high-risk behavior, empowers the client, and promotes maternal-fetal health without alienating the client.

Key Concept

Therapeutic Communication in High-Risk Prenatal Care
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Topics

High Risk Behaviors

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