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 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 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.