NORCET 2 - 2021 (shif…: A pregnant lady came into the hospital for ANC, which medicine prescribed by on duty doctor to prevent NTD?

NORCET 2 - 2021 (shift-1)

Obstetrics & Gynaecology

Easy

Appeared in: NORCET 2 - 2021 (shift-1)

Explanation

Folic acid, a B-vitamin (B9), is essential for the synthesis of DNA, RNA, and proteins, which are critical for cell division and growth.
Its primary role in pregnancy is to facilitate the closure of the neural tube during the first 28 days of embryonic development.
Insufficient folic acid levels during this critical period can result in failure of the neural tube to close, leading to severe birth defects of the brain and spine known as Neural Tube Defects (NTDs).
Periconceptional (before and in early pregnancy) supplementation with folic acid has been proven to reduce the incidence of NTDs by at least 50%.

Option B: Iron is a mineral essential for forming hemoglobin, the protein in red blood cells that carries oxygen. It is prescribed during pregnancy to prevent or treat maternal anemia and support the increased blood volume.
Option C: Zinc is a trace element that plays a role in cell growth, immune function, and the metabolism of proteins, carbohydrates, and fats. While important for overall fetal development, it is not the specific agent for NTD prevention.
Option D: Phosphate is a component of phosphorus, a mineral crucial for building strong bones and teeth, as well as for energy metabolism and cell structure. It is generally obtained through diet and is not routinely supplemented to prevent birth defects.

Clinical Relevance

Nursing practice connection: Knowing Pharmacological prevention of neural tube defects during pregnancy helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Nurses are at the forefront of patient education in antenatal clinics. They must emphasize the importance of starting folic acid before conception, as the neural tube closes before many women are aware of their pregnancy.
During ANC visits, it is a critical nursing responsibility to assess for risk factors that warrant a higher dose of folic acid, such as a family history of NTDs, maternal diabetes, or use of medications like valproic acid.
What if? If the pregnant lady reported that her previous child was born with spina bifida, the standard 400 mcg dose would be insufficient. The nurse should anticipate a prescription for a high dose of 4-5 mg of folic acid daily, starting at least one month before the next planned conception.

How to Approach the Question

First, identify the key clinical terms in the question: 'pregnant lady', 'ANC' (Antenatal Care), and 'prevent NTD' (Neural Tube Defect).
The question asks for a specific medication to prevent a specific, well-known birth defect.
Access your knowledge base on routine prenatal care and supplementation. The link between folic acid and NTD prevention is a fundamental concept in obstetrics.
Evaluate each option's primary function in pregnancy. Folic acid is directly and specifically indicated for NTD prevention.
Consider the other options. Iron is for anemia, Zinc is for general growth, and Phosphate is for bones. These are not the primary agents for preventing NTDs.
Conclude that Folic acid is the only option that directly addresses the prevention of Neural Tube Defects.

Concept Tested & Keywords

Concept Tested: Pharmacological prevention of neural tube defects during pregnancy
Stem keywords: pregnant lady, ANC, prevent NTD
Lead-in keywords: which medicine
Clinical cues: Antenatal Care (ANC) setting implies routine pregnancy management.
Clinical cues: The goal is prevention of Neural Tube Defect (NTD), a specific congenital anomaly.

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