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 ["A","C","D","E"]
Explanation
Choice A rationale
Nausea is a common symptom during pregnancy, especially in the first trimester. It is often referred to as morning sickness, although it can occur at any time of the day. The client’s report of nausea almost every day for the last two months, but lasting for a shorter period of the day, is consistent with typical pregnancy-related nausea.
Choice B rationale
Malodorous vaginal discharge is not a common or expected physiological change during pregnancy. It may indicate an infection or other medical condition that requires further evaluation and treatment.
Choice C rationale
Increased frequency of urination is a common symptom during pregnancy. It occurs due to hormonal changes and the growing uterus putting pressure on the bladder. The client’s report of voiding more frequently without pain is consistent with normal physiological changes during pregnancy.
Choice D rationale
Fundal height measurement is used to assess fetal growth and development. At 18 weeks of gestation, the fundal height is typically around 18 cm, which corresponds to the number of weeks of pregnancy. This finding is consistent with expected physiological changes during pregnancy.
Choice E rationale
The darkened line of skin noted midline on the abdomen, known as the linea nigra, is a common physiological change during pregnancy. It is caused by increased pigmentation and is a normal finding.
Choice F rationale
A dry, reddened patch of skin below the knee bilaterally is not a common or expected physiological change during pregnancy. It may indicate a dermatological condition or other medical issue that requires further evaluation.
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.