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","C","D","E"]
Explanation
Choice A rationale
Nausea is a common symptom during pregnancy, especially in the first trimester. It is often referred to as morning sickness, although it can occur at any time of the day. The client’s report of nausea almost every day for the last two months, but lasting for a shorter period of the day, is consistent with typical pregnancy-related nausea.
Choice B rationale
Malodorous vaginal discharge is not a common or expected physiological change during pregnancy. It may indicate an infection or other medical condition that requires further evaluation and treatment.
Choice C rationale
Increased frequency of urination is a common symptom during pregnancy. It occurs due to hormonal changes and the growing uterus putting pressure on the bladder. The client’s report of voiding more frequently without pain is consistent with normal physiological changes during pregnancy.
Choice D rationale
Fundal height measurement is used to assess fetal growth and development. At 18 weeks of gestation, the fundal height is typically around 18 cm, which corresponds to the number of weeks of pregnancy. This finding is consistent with expected physiological changes during pregnancy.
Choice E rationale
The darkened line of skin noted midline on the abdomen, known as the linea nigra, is a common physiological change during pregnancy. It is caused by increased pigmentation and is a normal finding.
Choice F rationale
A dry, reddened patch of skin below the knee bilaterally is not a common or expected physiological change during pregnancy. It may indicate a dermatological condition or other medical issue that requires further evaluation.
Correct Answer is ["A","C","E"]
Explanation
Choice A rationale
Intrauterine growth restriction (IUGR) can result in a smaller fundal height measurement than expected for gestational age. This condition indicates that the fetus is not growing at the normal rate inside the womb.
Choice B rationale
A fundal height measurement of 19 centimeters at 22 weeks of gestation is not consistent with the estimated gestational age by LMP. Typically, the fundal height in centimeters should be approximately equal to the number of weeks of gestation.
Choice C rationale
Fetal anomalies can affect the size and growth of the fetus, leading to discrepancies in fundal height measurements. This could result in a smaller or larger than expected measurement.
Choice D rationale
Polyhydramnios, or excessive amniotic fluid, would typically result in a larger fundal height measurement than expected for gestational age. Therefore, this choice is incorrect.
Choice E rationale
Miscalculation of the due date can lead to discrepancies in fundal height measurements. If the gestational age is miscalculated, the fundal height may not match the expected measurement for the given weeks of gestation.