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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).

A.

Intrauterine growth restriction.

B.

Consistent for estimated gestational age by LMP.

C.

Fetal anomaly.

D.

Polyhydramnios.

E.

Miscalculation of due date.

Question Solution

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 D

Explanation

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.

Correct Answer is C

Explanation

Choice A rationale

Changing professions is not necessary solely due to pregnancy. However, it is important to consider the specific risks associated with the current job. In this case, the client works in a hair and nail salon, which may expose her to various chemicals and environmental toxins. These toxins can pose risks to both the mother and the developing fetus. Therefore, the focus should be on minimizing exposure to these hazards rather than changing professions altogether.

Choice B rationale

While it is important to be mindful of weight limits during pregnancy to avoid strain and injury, this is not the primary concern for a client working in a hair and nail salon. The main risk in this scenario is exposure to environmental toxins, which can have more significant implications for the health of the mother and the developing fetus.

Choice C rationale

Exposure to environmental toxins is a significant concern for pregnant women working in hair and nail salons. These environments often contain chemicals such as formaldehyde, toluene, and phthalates, which can be harmful to both the mother and the developing fetus. Educating the client about the risks associated with these toxins and providing guidance on how to minimize exposure is crucial for ensuring a healthy pregnancy.

Choice D rationale

While reducing the number of clients seen in a day may help manage physical strain and fatigue, it does not address the primary concern of exposure to environmental toxins. The focus should be on minimizing contact with harmful chemicals and ensuring a safe working environment for the pregnant client.

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