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
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.
Correct Answer is C
Explanation
Choice A rationale
Providing additional information about the disorder is appropriate as it helps the couple understand the condition better and prepare for the future. This information can include the nature of the disorder, potential complications, and available treatments or interventions.
Choice B rationale
Referring the couple to a disorder-specific support group is also appropriate. Support groups can provide emotional support, practical advice, and a sense of community for families facing similar challenges. This can help the couple cope with the diagnosis and connect with others who have similar experiences.
Choice C rationale
Determining whether termination has been considered is inappropriate because the couple has already decided to continue the pregnancy. Bringing up termination at this point can be distressing and may undermine their decision. The nurse should respect their choice and focus on providing support and information relevant to continuing the pregnancy.
Choice D rationale
Explaining that they may experience grief, which is normal, is appropriate. Grief is a common response to learning about a serious genetic disorder in a fetus, and normalizing these feelings can help the couple process their emotions and seek appropriate support.