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
Changing professions is not necessary solely due to pregnancy. However, it is important to consider the specific risks associated with the current job. In this case, the client works in a hair and nail salon, which may expose her to various chemicals and environmental toxins. These toxins can pose risks to both the mother and the developing fetus. Therefore, the focus should be on minimizing exposure to these hazards rather than changing professions altogether.
Choice B rationale
While it is important to be mindful of weight limits during pregnancy to avoid strain and injury, this is not the primary concern for a client working in a hair and nail salon. The main risk in this scenario is exposure to environmental toxins, which can have more significant implications for the health of the mother and the developing fetus.
Choice C rationale
Exposure to environmental toxins is a significant concern for pregnant women working in hair and nail salons. These environments often contain chemicals such as formaldehyde, toluene, and phthalates, which can be harmful to both the mother and the developing fetus. Educating the client about the risks associated with these toxins and providing guidance on how to minimize exposure is crucial for ensuring a healthy pregnancy.
Choice D rationale
While reducing the number of clients seen in a day may help manage physical strain and fatigue, it does not address the primary concern of exposure to environmental toxins. The focus should be on minimizing contact with harmful chemicals and ensuring a safe working environment for the pregnant client.
Correct Answer is C
Explanation
Choice A rationale
The placenta does not cushion the fetus from maternal movement. Instead, the amniotic fluid within the amniotic sac provides cushioning and protection to the fetus from external forces and maternal movements.
Choice B rationale
The placenta does not provide thermoregulation. Thermoregulation is primarily managed by the mother’s body. The placenta’s main functions are related to nutrient and gas exchange, hormone production, and waste removal.
Choice C rationale
The placenta is responsible for metabolic and gas exchange. It provides oxygen and nutrients to the fetus while removing waste products from the fetal blood. This exchange occurs through the placental barrier, which separates maternal and fetal blood.
Choice D rationale
The placenta does not provide a sterile environment. The amniotic sac and its fluid help maintain a sterile environment for the fetus. The placenta’s role is more focused on nutrient and gas exchange, hormone production, and waste removal.