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
This choice indicates G3-T1-P0-A1-L2. Gravida (G) is the total number of pregnancies, which is correct as 3. Term (T) is the number of pregnancies carried to term (37 weeks or more), which is 1. Preterm (P) is the number of pregnancies delivered between 20 and 36 weeks, which is 0. Abortions (A) is the number of pregnancies lost before 20 weeks, which is 1. Living (L) is the number of living children, which is 2. However, this choice incorrectly counts the preterm delivery as an abortion.
Choice B rationale
This choice indicates G3-T2-P0-A0-L2. Gravida (G) is correct as 3. Term (T) is the number of pregnancies carried to term, which is 2. Preterm (P) is the number of pregnancies delivered between 20 and 36 weeks, which is 0. Abortions (A) is the number of pregnancies lost before 20 weeks, which is 0. Living (L) is the number of living children, which is 2. This choice incorrectly counts the preterm delivery as a term delivery.
Choice C rationale
This choice indicates G3-T1-P1-A0-L2. Gravida (G) is correct as 3. Term (T) is the number of pregnancies carried to term, which is 1. Preterm (P) is the number of pregnancies delivered between 20 and 36 weeks, which is 1. Abortions (A) is the number of pregnancies lost before 20 weeks, which is 0. Living (L) is the number of living children, which is 2. This choice correctly accounts for the term and preterm deliveries.
Choice D rationale
This choice indicates G2-T1-P1-A0-L2. Gravida (G) is incorrect as it should be 3. Term (T) is the number of pregnancies carried to term, which is 1. Preterm (P) is the number of pregnancies delivered between 20 and 36 weeks, which is 1. Abortions (A) is the number of pregnancies lost before 20 weeks, which is 0. Living (L) is the number of living children, which is 2. This choice incorrectly counts the total number of pregnancies.
Correct Answer is B
Explanation
Choice A rationale
Lisinopril is not a beta blocker; it is an ACE inhibitor. Beta blockers, such as metoprolol, are generally considered safer during pregnancy compared to ACE inhibitors. Beta blockers work by blocking the effects of adrenaline on your heart and blood vessels, which helps to lower blood pressure. However, they are not without risks and should be used under medical supervision during pregnancy.
Choice B rationale
Lisinopril is an ACE inhibitor, which is contraindicated during pregnancy, especially in the second and third trimesters. ACE inhibitors can cause fetal renal dysfunction, oligohydramnios, and even fetal death. Therefore, it is essential to discuss alternative medications that are safer during pregnancy.
Choice C rationale
This statement is incorrect because ACE inhibitors, including lisinopril, are not safe to continue during pregnancy. They pose significant risks to the fetus, particularly in the later stages of pregnancy.
Choice D rationale
Lisinopril is not an angiotensin II receptor blocker (ARB); it is an ACE inhibitor. ARBs, like ACE inhibitors, are also contraindicated during pregnancy due to similar risks of fetal toxicity and adverse outcomes.