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
The mother’s size does not significantly impact the effects of teratogen exposure on fetal development. Teratogens are substances that cause congenital abnormalities in a developing fetus, and their impact is more related to the timing, duration, and type of exposure rather than the mother’s physical characteristics.
Choice B rationale
The timing and duration of exposure are critical factors in determining the effects of teratogen exposure. Teratogens can cause the most harm during specific periods of fetal development, particularly during the first trimester when organogenesis occurs. The duration of exposure also influences the severity of the effects, with prolonged exposure leading to more significant developmental issues.
Choice C rationale
The type of teratogen is also important, as different teratogens can cause different types of congenital abnormalities. For example, alcohol can lead to fetal alcohol syndrome, while certain medications can cause neural tube defects. However, the timing and duration of exposure are generally considered more critical factors.
Choice D rationale
The father’s health does not directly impact the effects of teratogen exposure on fetal development. Teratogens affect the fetus through the mother’s exposure to harmful substances during pregnancy.