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
Not providing resources immediately may leave the patient feeling unsupported and isolated. It is important to offer resources and support to help the patient cope with the emotional and psychological impact of terminating a pregnancy due to a genetic abnormality.
Choice B rationale
Discussing the stages of grief is an appropriate nursing action. It helps the patient understand that their feelings are normal and provides a framework for processing their emotions. This support can be crucial in helping the patient navigate their grief and begin the healing process.
Choice C rationale
Encouraging the patient to rethink their decision is not appropriate. The decision to terminate a pregnancy due to a genetic abnormality is often difficult and deeply personal. It is important to respect the patient’s decision and provide support rather than questioning their choice.
Choice D rationale
Encouraging the couple not to share their emotions with each other can be harmful. Open communication between partners is essential for mutual support and understanding during such a challenging time. Encouraging them to share their feelings can strengthen their relationship and help them cope with the loss together.
Correct Answer is B
Explanation
Choice A rationale
This response is dismissive and does not address the client’s feelings. It may make the client feel invalidated and unsupported.
Choice B rationale
This response acknowledges that ambivalent feelings are common in early pregnancy. It normalizes the client’s feelings and provides reassurance, which is appropriate and supportive.
Choice C rationale
This response imposes an expectation of happiness on the client, which may make her feel guilty or inadequate for not feeling happy. It does not validate her current feelings.
Choice D rationale
This response redirects the client’s feelings to another person (her mother) rather than addressing them directly. It may not be helpful if the client does not have a supportive relationship with her mother.