A 6-month pregnant woman comes to the hospital for consultation. Which of the following is contraindicated?

Appeared in: WCL Staff Nurse - 2019

Explanation

High doses of preformed Vitamin A (Retinol) are teratogenic, meaning they can cause significant birth defects.
The dose of 2 Lakh IU (200,000 IU) is a massive overdose for a pregnant woman; the recommended upper limit is around 10,000 IU per day.
Teratogenic effects of excessive Vitamin A include craniofacial abnormalities (like cleft palate), central nervous system malformations, and cardiac defects.
This high dose is typically reserved for postpartum mothers in areas with Vitamin A deficiency to boost their health and the vitamin content of their breast milk.

Option A: Tetanus Toxoid (TT) vaccine is not contraindicated; it is a recommended and essential part of routine antenatal care.
Option B: While a high dose of 200 mg of Potassium Iodide is indeed contraindicated as it can cause fetal goiter, the teratogenic risk of high-dose Retinol is more severe and a more classic contraindication.
Option C: Ferrous Sulphate is a standard, recommended supplement during pregnancy to prevent or treat iron-deficiency anemia.

Clinical Relevance

Nursing practice connection: Use the key finding related to Pharmacology and Contraindications in Pregnancy to guide bedside assessment, documentation, and the next nursing action.
A key nursing responsibility during antenatal care is patient education about safe medication and supplement use.
Nurses must specifically warn pregnant women against taking over-the-counter high-dose vitamin supplements without consulting a healthcare provider.
What if? If the woman was postpartum and breastfeeding in a region with endemic vitamin A deficiency, this 2 Lakh IU dose of Retinol might be indicated as part of a public health program to be given once to the mother.

How to Approach the Question

First, identify the core of the question, which is to find a 'contraindication' for a pregnant woman.
Evaluate each option against standard antenatal care guidelines.
Recall that Tetanus Toxoid and Iron (Ferrous Sulphate) are routinely recommended during pregnancy.
Compare the remaining two options: Potassium Iodide and Retinol. Both are harmful in high doses.
Recognize that high-dose Vitamin A (Retinol) is a well-known, potent teratogen, making it the most significant and absolute contraindication among the choices.
Select the option that poses the greatest and most established risk to the fetus.

Concept Tested & Keywords

Concept Tested: Pharmacology and Contraindications in Pregnancy
Stem keywords: 6-month pregnant woman, consultation, contraindicated
Lead-in keywords: Which of the following
Clinical cues: The term 'contraindicated' is an absolute, meaning the substance should not be used.

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E6 Parks TextBook of Preventive & Social Medicine part 2 — Subpart A (pp 1-232 of 464) pp. 22-24, 21-23

E6 Comprehensive Textbook of Community Health Nursing for BSc Nursing Students Part 2 — Subpart A (pp 1-275 of 550) p. 193-195

Practise the full WCL Staff Nurse - 2019

Attempt every question from this paper in a timed mock, then review the full solution for each one.