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
Adrenocorticotropic hormone (ACTH) is produced by the pituitary gland and stimulates the adrenal glands to release cortisol. It is not involved in the maturation of ovarian follicles.
Choice B rationale
Follicle-stimulating hormone (FSH) is produced by the pituitary gland and stimulates the growth and maturation of ovarian follicles. It is the correct hormone involved in the follicular phase of the ovarian cycle.
Choice C rationale
Oxytocin is a hormone involved in childbirth and lactation. It stimulates uterine contractions and milk ejection but is not involved in the maturation of ovarian follicles.
Choice D rationale
Luteinizing hormone (LH) is produced by the pituitary gland and triggers ovulation and the formation of the corpus luteum. It is not involved in the maturation of ovarian follicles during the follicular phase.
Choice E rationale
Prolactin is a hormone that stimulates milk production in the mammary glands. It is not involved in the maturation of ovarian follicles.
Choice F rationale
Progesterone is a hormone produced by the corpus luteum and the placenta during pregnancy. It prepares the endometrium for implantation and maintains pregnancy but is not involved in the maturation of ovarian follicles.
Correct Answer is B
Explanation
Choice A rationale
Oligohydramnios refers to a condition where there is too little amniotic fluid. An amniotic fluid volume of 1900 mL is above the normal range, indicating that oligohydramnios is not present.
Choice B rationale
Polyhydramnios is the condition of having too much amniotic fluid. The normal range for amniotic fluid volume at 34 weeks gestation is between 800 and 1000 mL. An estimated volume of 1900 mL indicates polyhydramnios, which can be associated with various maternal and fetal conditions.
Choice C rationale
A follow-up glucose test is not directly indicated by the finding of polyhydramnios. While polyhydramnios can be associated with gestational diabetes, the decision to perform a glucose test would depend on other clinical factors and the patient’s history.
Choice D rationale
An amniotic fluid volume of 1900 mL is above the normal range for 34 weeks gestation, so it is not considered normal for gestational age. This finding indicates polyhydramnios rather than a normal fluid level.