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 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.
Correct Answer is A
Explanation
Choice A rationale
The uterus can indeed increase in size by 20 times its non-pregnant size. This significant expansion is necessary to accommodate the growing fetus and the increased blood supply required during pregnancy.
Choice B rationale
While the weight of the uterus does increase significantly during pregnancy, from about 100 grams to approximately 1,000 grams, this statement does not directly address the client’s concern about the uterus’s ability to stretch.
Choice C rationale
About 25% of the increased capacity of the uterus is related to uteroplacental content, but this does not fully explain the uterus’s ability to stretch to accommodate a full-term baby.
Choice D rationale
The increase in uterus size during pregnancy is not solely related to amniotic fluid volume. The uterus itself grows and stretches significantly to accommodate the developing fetus.