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","C","E"]
Explanation
Choice A rationale
Lying down after meals can exacerbate heartburn by allowing stomach acid to flow back into the esophagus. It is generally recommended to remain upright after eating to help prevent this.
Choice B rationale
Remaining upright after meals helps prevent heartburn by keeping stomach acid in the stomach and reducing the likelihood of acid reflux. This can be achieved by sitting or standing for at least 30 minutes after eating.
Choice C rationale
Eating small, frequent meals can help prevent heartburn by reducing the amount of food in the stomach at any one time, which decreases the pressure on the stomach and the likelihood of acid reflux.
Choice D rationale
Drinking large amounts of water before meals can increase the volume in the stomach and may exacerbate heartburn. It is generally better to drink fluids between meals rather than before or during meals.
Choice E rationale
Discussing antacid recommendations with the provider is appropriate. Antacids can help neutralize stomach acid and provide relief from heartburn, but it is important to consult with a healthcare provider to ensure that the chosen antacid is safe for use during pregnancy.
Correct Answer is C
Explanation
Choice A rationale
The recommended limit for caffeine intake during pregnancy is generally 200 mg or less per day. Consuming 400 mg of caffeine daily exceeds this recommendation and may increase the risk of adverse pregnancy outcomes.
Choice B rationale
It is recommended to avoid alcohol entirely during pregnancy, as even small amounts can increase the risk of fetal alcohol spectrum disorders and other complications. Therefore, having one alcoholic beverage a week is not considered safe.
Choice C rationale
Drinking at least 8-10 cups of fluid each day is a good practice during pregnancy to maintain adequate hydration, support increased blood volume, and promote overall health. This statement indicates that the client understood the education provided.
Choice D rationale
Pregnant individuals should not decrease their intake of essential nutrients like calcium, magnesium, iron, and vitamin D. These nutrients are important for fetal development and maternal health. Instead, they should ensure they are getting adequate amounts through diet and supplements as recommended by their healthcare provider.