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Difficulty: MediumHigh Risk Behaviors

A clinic nurse is providing education to a pregnant client at 10 weeks of gestation who reports using cannabis daily to manage severe morning sickness. The client states, "It is a natural plant, so I feel it is much safer for my baby than taking prescription chemicals." Which of the following responses by the nurse are appropriate? (Select all that apply.)

  1. Although cannabis is a natural plant, smoking it exposes your fetus to carbon monoxide, which decreases the oxygen supply.Answer
  2. The active compound in cannabis crosses the placenta and can negatively affect your baby's brain development.Answer
  3. Let's explore FDA-approved medications and dietary changes that are proven safe for managing nausea during pregnancy.Answer
  4. D
    If you switch to consuming cannabis in edible forms, you will eliminate the risk of harm to your developing baby.
  5. E
    Because you are self-medicating with a controlled substance, I am required to immediately report you to child protective services.
  6. F
    Cannabis use is primarily dangerous during the third trimester, so you should aim to quit before then.

Answer

The appropriate responses include explaining that smoking exposes the fetus to carbon monoxide, noting that active compounds cross the placenta to affect brain development, and offering to explore FDA-approved safe alternatives for nausea.
The correct statements prioritize evidence-based harm reduction and therapeutic communication. Cannabis is contraindicated during pregnancy. Smoking introduces carbon monoxide into the maternal bloodstream, which readily crosses the placenta and decreases fetal oxygenation. Furthermore, THC crosses the placental barrier and has been linked to long-term cognitive and neurodevelopmental issues. Offering safe, FDA-approved pharmacological and non-pharmacological alternatives for hyperemesis gravidarum addresses the client's underlying symptom while maintaining a supportive, non-judgmental environment.

Step-by-Step Solution

1
Analyze the client's statement and underlying need.
The client is experiencing severe nausea and using a potentially harmful substance due to a misconception that 'natural' means 'safe' for the fetus.
Understanding the client's rationale is necessary to provide targeted harm-reduction education without judgment.
2
Evaluate the physiological risks of the high-risk behavior.
Cannabis use during pregnancy, regardless of route, introduces THC to the fetus, impacting neurodevelopment. Smoking specifically adds the risk of carbon monoxide exposure, leading to fetal hypoxia.
Accurate, evidence-based facts must be used to correct the client's misconception.
3
Select interventions that maintain therapeutic communication and promote maternal-fetal safety.
Providing factual education about fetal risks while offering safe, medical alternatives addresses the problem constructively.
Punitive responses or false reassurances break trust and violate the principles of therapeutic communication and health promotion.

Key Concept

Harm Reduction and Substance Use During Pregnancy
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Topics

High Risk Behaviors

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