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
Fetal movements, known as quickening, are typically felt by the mother between 16 and 25 weeks of pregnancy, not specifically at week 245.
Choice B rationale
The baby’s heartbeat can be detected by 10-12 weeks of pregnancy using a Doppler ultrasound device. This is an important milestone in fetal development and prenatal care
.
Choice C rationale
Lanugo, the fine hair covering the fetus, usually appears around 20 weeks of pregnancy and starts to disappear closer to the end of the third trimester, not specifically by week 355.
Choice D rationale
The sex of the baby is determined at conception, but it can be detected via ultrasound around 18-20 weeks of pregnancy, not by week 85.
Correct Answer is B
Explanation
Choice A rationale
This response is dismissive and does not address the client’s feelings. It may make the client feel invalidated and unsupported.
Choice B rationale
This response acknowledges that ambivalent feelings are common in early pregnancy. It normalizes the client’s feelings and provides reassurance, which is appropriate and supportive.
Choice C rationale
This response imposes an expectation of happiness on the client, which may make her feel guilty or inadequate for not feeling happy. It does not validate her current feelings.
Choice D rationale
This response redirects the client’s feelings to another person (her mother) rather than addressing them directly. It may not be helpful if the client does not have a supportive relationship with her mother.