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
Providing additional information about the disorder is appropriate as it helps the couple understand the condition better and prepare for the future. This information can include the nature of the disorder, potential complications, and available treatments or interventions.
Choice B rationale
Referring the couple to a disorder-specific support group is also appropriate. Support groups can provide emotional support, practical advice, and a sense of community for families facing similar challenges. This can help the couple cope with the diagnosis and connect with others who have similar experiences.
Choice C rationale
Determining whether termination has been considered is inappropriate because the couple has already decided to continue the pregnancy. Bringing up termination at this point can be distressing and may undermine their decision. The nurse should respect their choice and focus on providing support and information relevant to continuing the pregnancy.
Choice D rationale
Explaining that they may experience grief, which is normal, is appropriate. Grief is a common response to learning about a serious genetic disorder in a fetus, and normalizing these feelings can help the couple process their emotions and seek appropriate support.
Correct Answer is C
Explanation
Choice A rationale
Intimate partner violence (IPV) does not necessarily decrease during pregnancy. In fact, pregnancy can sometimes increase the risk of IPV due to various stressors and changes in the relationship dynamics.
Choice B rationale
IPV consists of more than just physical abuse. It can also include emotional, psychological, and sexual abuse. Emotional abuse can involve manipulation, threats, and controlling behavior, while sexual abuse includes any non-consensual sexual activity.
Choice C rationale
IPV can indeed include emotional, physical, and sexual abuse. This comprehensive understanding is crucial for recognizing and addressing all forms of IPV, as each type can have severe and lasting impacts on the victim’s health and well-being.
Choice D rationale
IPV is not rare; it is a common issue affecting millions of people worldwide. It can occur in any demographic and socioeconomic group, making it a significant public health concern.