A nurse is caring for a client in the obstetric clinic who is 22 weeks of gestation, calculated by her last menstrual period.The fundal height measurement is 19 centimeters.This measurement could indicate which of the following? (Select all that apply).
Intrauterine growth restriction.
Consistent for estimated gestational age by LMP.
Fetal anomaly.
Polyhydramnios.
Miscalculation of due date.
Correct Answer : A,C,E
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.
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Correct Answer is C
Explanation
Choice A rationale
Heartburn and nausea are common symptoms during pregnancy and are not typically considered warning signs that require immediate medical attention.
Choice B rationale
Amenorrhea, or the absence of menstruation, is a normal sign of pregnancy and does not indicate a complication that needs immediate reporting.
Choice C rationale
Abdominal cramping can be a sign of a serious condition such as ectopic pregnancy or miscarriage, and it is important for the client to report this symptom immediately.
Choice D rationale
Urinary frequency is a common symptom during pregnancy due to hormonal changes and the growing uterus pressing on the bladder. It is not typically a warning sign that requires immediate medical attention.
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.