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 B
Explanation
Choice A rationale
Lisinopril is not a beta blocker; it is an ACE inhibitor. Beta blockers, such as metoprolol, are generally considered safer during pregnancy compared to ACE inhibitors. Beta blockers work by blocking the effects of adrenaline on your heart and blood vessels, which helps to lower blood pressure. However, they are not without risks and should be used under medical supervision during pregnancy.
Choice B rationale
Lisinopril is an ACE inhibitor, which is contraindicated during pregnancy, especially in the second and third trimesters. ACE inhibitors can cause fetal renal dysfunction, oligohydramnios, and even fetal death. Therefore, it is essential to discuss alternative medications that are safer during pregnancy.
Choice C rationale
This statement is incorrect because ACE inhibitors, including lisinopril, are not safe to continue during pregnancy. They pose significant risks to the fetus, particularly in the later stages of pregnancy.
Choice D rationale
Lisinopril is not an angiotensin II receptor blocker (ARB); it is an ACE inhibitor. ARBs, like ACE inhibitors, are also contraindicated during pregnancy due to similar risks of fetal toxicity and adverse outcomes.
Correct Answer is D
Explanation
Choice A rationale
A 25%-35% increase in blood volume is lower than the actual increase observed during pregnancy. This choice is incorrect.
Choice B rationale
A 10%-20% increase in blood volume is significantly lower than the actual increase observed during pregnancy. This choice is incorrect.
Choice C rationale
A 60%-70% increase in blood volume is higher than the actual increase observed during pregnancy. This choice is incorrect.
Choice D rationale
The correct percentage of increased blood volume during pregnancy is 40%-50%. This increase helps accommodate the growing fetus and placenta, and prepares the body for the blood loss that occurs during delivery.