A nurse is calculating the estimated date of delivery for a patient who reports that the first day of her last menstrual period was August 10. Using Nägele’s Rule, what is the patient’s estimated date of delivery?

Choice A rationale
Frequent urination is a common symptom in early pregnancy due to the increased blood flow to the woman’s kidneys. This is a normal physiological change and does not require immediate attention.
Choice B rationale
Severe vomiting at 8 weeks of gestation could indicate hyperemesis gravidarum, a severe form of nausea and vomiting in pregnancy that can lead to dehydration and weight loss. This

condition requires immediate medical attention as it can have serious health implications for both the mother and the baby.
Choice C rationale
Back pain following intercourse at 36 weeks of gestation could be a sign of labor. However, it is not as urgent as severe vomiting in early pregnancy which can lead to dehydration.
Choice D rationale
Periodic tingling of the fingers at 24 weeks of gestation could be due to physiological changes in pregnancy such as fluid retention causing carpal tunnel syndrome. While this can be uncomfortable, it is not a medical emergency.

The correct answer is choice d. Assist the client to the bathroom.

Choice A rationale:

Inserting a urinary catheter is an invasive procedure and should be considered only after less invasive measures have been attempted and failed. It carries risks such as infection and trauma to the urethra.

Choice B rationale:

Pouring warm water over the client’s perineum can help stimulate urination, but it should be tried after assisting the client to the bathroom. It is a non-invasive method but not the first action to take.

Choice C rationale:

Offering a sitz bath can also help with urination by relaxing the perineal muscles, but it is not the first action to take. It is more appropriate if the client is unable to void after trying to use the bathroom.

Choice D rationale:

Assisting the client to the bathroom is the least invasive and most straightforward initial action. It allows the client to attempt to void naturally, which is preferable before trying other interventions.