A nurse is caring for a client at 34 weeks gestation.

Medical History: The client has a history of gestational diabetes and mild hypertension.

Diagnostic Results: The latest ultrasound shows normal fetal growth and development. Blood sugar levels have been slightly elevated in the past week.

Vital Signs: Blood pressure has been steadily increasing over the past few hours. Heart rate and temperature remain within normal limits.

Complete the diagram by selecting the condition the client is most likely experiencing? Two actions the nurse should take to address that condition and two parameters the nurse should monitor to assess the client’s progress

Choice A:
It is incorrect to state that all women will start to feel the baby move at 24 weeks. While this is a common timeframe, the exact timing of when a woman first feels fetal movements, known as quickening, can vary. Some women may feel movement as early as 16 weeks, while others may not feel it until closer to 25 weeks. Factors such as the position of the placenta, the woman's body size, and whether it is her first pregnancy can influence when she first perceives movement.
Choice B:
While the baby's sex is genetically determined at conception, it is not typically visible on ultrasound until around 18-20 weeks of gestation. This is due to the development of the external genitalia, which occurs between 11 and 14 weeks. It is not accurate to state that the sex is always definitively determined by week 8.
Choice D:
Lanugo, the fine hair that covers a fetus's body, is typically present between 14 and 20 weeks of gestation. It starts to disappear around 32-36 weeks, and most babies are born without it. Therefore, it is incorrect to say that lanugo covers the entire body at 36 weeks.
Choice C:
The fetal heartbeat can be detected by a Doppler stethoscope as early as 10-12 weeks of gestation. This is often a reassuring milestone for pregnant women, as it provides audible confirmation of the baby's presence and well-being. It is a common practice for healthcare providers to use a Doppler stethoscope during prenatal visits to assess the fetal heart rate and monitor fetal development.

Choice A:
The umbilicus is typically the location of the fundus at around 20 weeks of gestation, not 22 weeks.
If the fundus is at the umbilicus at 22 weeks, it could indicate that the fetus is not growing at the expected rate. This would warrant further investigation, such as an ultrasound, to assess fetal growth and development.

Choice C:
3 cm below the umbilicus is too low for a 22-week gestation.
This would suggest that the fetus is smaller than expected for the gestational age.
Possible causes of this include incorrect dating of the pregnancy, fetal growth restriction, or oligohydramnios (low amniotic fluid).

Choice D:
5 cm above the umbilicus is too high for a 22-week gestation.
This could indicate that the woman is carrying multiples, has polyhydramnios (excess amniotic fluid), or that the fetus is larger than expected for the gestational age (macrosomia).
Importance of Fundal Height Measurement:
Fundal height measurement is a simple, non-invasive way to assess fetal growth and development during pregnancy. It is typically measured at each prenatal appointment, starting at around 20 weeks of gestation.
By tracking the fundal height over time, healthcare providers can identify potential problems with fetal growth and make necessary interventions.