A client at 34 weeks gestation is undergoing an ultrasound.The report shows the amniotic fluid volume is estimated at 1900 mL. Which deduction does the nurse make from this finding?
Oligohydramnios is present.
Polyhydramnios is present.
Follow-up glucose test is warranted.
Fluid is normal for gestational age.
The Correct Answer is B
Choice A rationale
Oligohydramnios refers to a condition where there is too little amniotic fluid. An amniotic fluid volume of 1900 mL is above the normal range, indicating that oligohydramnios is not present.
Choice B rationale
Polyhydramnios is the condition of having too much amniotic fluid. The normal range for amniotic fluid volume at 34 weeks gestation is between 800 and 1000 mL. An estimated volume of 1900 mL indicates polyhydramnios, which can be associated with various maternal and fetal conditions.
Choice C rationale
A follow-up glucose test is not directly indicated by the finding of polyhydramnios. While polyhydramnios can be associated with gestational diabetes, the decision to perform a glucose test would depend on other clinical factors and the patient’s history.
Choice D rationale
An amniotic fluid volume of 1900 mL is above the normal range for 34 weeks gestation, so it is not considered normal for gestational age. This finding indicates polyhydramnios rather than a normal fluid level.
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Correct Answer is A
Explanation
Choice A rationale
The ductus venosus, foramen ovale, and ductus arteriosus are shunts in fetal circulation that bypass the lungs and liver, directing oxygenated blood to the brain and body. The foramen ovale allows blood to flow from the right atrium to the left atrium, bypassing the lungs. The ductus arteriosus connects the pulmonary artery to the aorta, allowing blood to bypass the lungs. The ductus venosus shunts blood from the umbilical vein to the inferior vena cava, bypassing the liver.
Choice B rationale
This choice is incorrect because the primary purpose of these shunts is not to ensure proper development of the fetal heart. While they do play a role in directing blood flow, their main function is to bypass the non-functional fetal lungs and liver.
Choice C rationale
This choice is incorrect because the shunts are not primarily involved in regulating blood pressure in the fetus. Their main function is to direct oxygenated blood to vital organs like the brain and heart.
Choice D rationale
This choice is incorrect because the shunts bypass the lungs, which are not yet functional in the fetus. Gas exchange occurs in the placenta, not the fetal lungs.
Correct Answer is C
Explanation
Choice A rationale
A blood transfusion just after delivery is not a standard intervention for a client with Rh-negative blood type. The primary concern for Rh-negative clients is the potential for Rh incompatibility with the fetus, which can lead to hemolytic disease of the newborn. This condition is prevented by administering RhO(D) immune globulin during pregnancy.
Choice B rationale
Maternal serum alpha-fetoprotein (MSAFP) testing is used to screen for certain fetal abnormalities, such as neural tube defects, but it is not specifically related to Rh incompatibility. The primary intervention for Rh-negative clients is the administration of RhO(D) immune globulin to prevent sensitization.
Choice C rationale
RhO(D) immune globulin is administered at around 28 weeks of gestation to prevent Rh sensitization in Rh-negative clients. This intervention is crucial for preventing the development of antibodies that could harm the fetus in current or future pregnancies.
Choice D rationale
A three-hour glucose tolerance test is used to screen for gestational diabetes, which is a separate concern from Rh incompatibility. The primary intervention for Rh-negative clients is the administration of RhO(D) immune globulin.