A nurse in a prenatal clinic is caring for a client who asks what her estimated date of delivery will be if her last menstrual period began on November 15th.Which of the following is the appropriate response by the nurse?
July 12.
August 12.
August 22.
July 22.
The Correct Answer is D
Choice A rationale
Calculating the estimated date of delivery (EDD) involves adding 280 days (40 weeks) to the first day of the last menstrual period (LMP). Starting from November 15th, adding 280 days results in an EDD around August 22nd, not July 12th.
Choice B rationale
Using the same calculation method, adding 280 days to November 15th results in an EDD around August 22nd, not August 12th.
Choice C rationale
This choice is close but not accurate. Adding 280 days to November 15th results in an EDD around August 22nd.
Choice D rationale
This is the correct calculation. Adding 280 days to November 15th results in an EDD around August 22nd.
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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.