A nurse is reinforcing teaching with a group of adolescent females who are pregnant about expected changes related to pregnancy.Which of the following client statements indicates understanding of the teaching?
“If I develop striae gravidarum, I need to call my provider immediately.”.
“My nipples and areola will become pale as my breasts enlarge.”.
“I should begin to recognize fetal movement by 10 weeks gestation.”.
“Some nausea and vomiting is normal, but I should call my provider if I am unable to keep food or water down.”.
The Correct Answer is D
Choice A rationale
Striae gravidarum, or stretch marks, are a common occurrence during pregnancy due to the rapid stretching of the skin. They are not a medical emergency and do not require immediate attention from a healthcare provider.
Choice B rationale
During pregnancy, the nipples and areola typically become darker, not paler, as the breasts enlarge. This change is due to hormonal influences and increased blood flow to the area.
Choice C rationale
Fetal movement, also known as quickening, is usually felt by the mother between 18 to 25 weeks of gestation, not as early as 10 weeks. At 10 weeks, the fetus is still too small for its movements to be felt by the mother.
Choice D rationale
Some nausea and vomiting, known as morning sickness, is normal during pregnancy. However, if a pregnant woman is unable to keep food or water down, it is important to contact a healthcare provider to ensure she and the baby are receiving adequate nutrition and hydration.
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Correct Answer is ["A","C","E","G"]
Explanation
Choice A rationale
Blood pressure is a critical parameter to monitor during pregnancy. Elevated blood pressure, as seen in this case (149/91 mmHg), can indicate the onset of hypertensive disorders such as preeclampsia, which can have severe consequences for both the mother and the fetus. Preeclampsia is characterized by high blood pressure and signs of damage to another organ system, often the kidneys. It is essential to report elevated blood pressure to the provider for further evaluation and management.
Choice B rationale
Gastrointestinal complaints, such as nausea and vomiting, are common during pregnancy due to hormonal changes. However, they are typically not a priority unless they are severe or accompanied by other concerning symptoms. In this case, the gastrointestinal complaints are mild and have been present for 2-3 weeks, which is consistent with normal early pregnancy symptoms.
Choice C rationale
Lower abdominal cramping can be a sign of various conditions, including normal uterine growth, gastrointestinal issues, or more serious concerns such as ectopic pregnancy or miscarriage. Given the patient’s report of vaginal spotting and mild abdominal cramping, it is crucial to report this to the provider to rule out any potential complications.
Choice D rationale
The hCG result is important for confirming pregnancy and monitoring its progression. However, in this context, it is not the most immediate priority compared to other symptoms. Elevated or abnormal hCG levels can indicate potential issues, but the presence of other symptoms such as spotting and cramping takes precedence.
Choice E rationale
Vaginal spotting during early pregnancy can be a sign of implantation bleeding, but it can also indicate more serious conditions such as threatened miscarriage or ectopic pregnancy. Given the patient’s report of spotting and cramping, it is essential to report this to the provider for further evaluation and management.
Choice F rationale
Heart rate is an important vital sign to monitor, but in this case, the patient’s heart rate is within the normal range for pregnancy. Therefore, it is not a priority to report unless there are other concerning symptoms or significant changes in heart rate.
Choice G rationale
Dysuria, or painful urination, can indicate a urinary tract infection (UTI), which is common during pregnancy and can lead to complications if left untreated. UTIs can cause discomfort and may lead to more serious infections such as pyelonephritis. It is important to report dysuria to the provider for appropriate testing and treatment.
Correct Answer is ["A","C","E"]
Explanation
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.