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 B
Explanation
Choice A rationale
Not providing resources immediately may leave the patient feeling unsupported and isolated. It is important to offer resources and support to help the patient cope with the emotional and psychological impact of terminating a pregnancy due to a genetic abnormality.
Choice B rationale
Discussing the stages of grief is an appropriate nursing action. It helps the patient understand that their feelings are normal and provides a framework for processing their emotions. This support can be crucial in helping the patient navigate their grief and begin the healing process.
Choice C rationale
Encouraging the patient to rethink their decision is not appropriate. The decision to terminate a pregnancy due to a genetic abnormality is often difficult and deeply personal. It is important to respect the patient’s decision and provide support rather than questioning their choice.
Choice D rationale
Encouraging the couple not to share their emotions with each other can be harmful. Open communication between partners is essential for mutual support and understanding during such a challenging time. Encouraging them to share their feelings can strengthen their relationship and help them cope with the loss together.
Correct Answer is D
Explanation
Choice A rationale
Having a child with blue eyes is not an indication for genetic testing. Eye color is a polygenic trait and does not typically warrant genetic testing.
Choice B rationale
Reactive airway disease in preterm children is not a direct indication for genetic testing. This condition is more related to the complications of prematurity rather than genetic factors.
Choice C rationale
Neonatal jaundice is common and usually resolves without long-term issues. It is not typically an indication for genetic testing unless there is a suspicion of an underlying genetic disorder.
Choice D rationale
Tay-Sachs Disease is a genetic disorder, and having a child with this condition is a strong indication for genetic testing. This would help determine the risk of recurrence in future pregnancies and provide valuable information for family planning. .