A nurse is caring for a client during an initial prenatal visit. The client’s last menstrual period was 18 weeks ago. Which of the following actions should the nurse plan to take?
Calculate the estimated date of birth.
Obtain the client’s personal and family medical history.
Obtain information about prior pregnancies.
Check the client’s urine with a reagent strip.
Schedule the client for prenatal laboratory testing.
Discuss chorionic villus sampling with the client.
Correct Answer : A,B,C,D,E
Choice A rationale
Calculating the estimated date of birth involves determining the gestational age. Gestational age is crucial for monitoring fetal development and timing prenatal care.
Choice B rationale
Obtaining the client’s personal and family medical history helps identify genetic risks, potential complications, and health conditions that may affect pregnancy and delivery.
Choice C rationale
Obtaining information about prior pregnancies provides insight into potential risks and outcomes. Previous pregnancy complications can indicate risks for the current pregnancy.
Choice D rationale
Checking the client’s urine with a reagent strip screens for urinary tract infections, protein, and glucose levels. UTIs can cause complications, while protein and glucose levels help monitor maternal health.
Choice E rationale
Scheduling the client for prenatal laboratory testing, such as blood work and ultrasounds, helps assess maternal and fetal health. Tests like blood type, Rh factor, and infectious diseases are essential for prenatal care.
Choice F rationale
Discussing chorionic villus sampling is not necessary at 18 weeks of gestation. CVS is typically performed between 10-13 weeks for early genetic testing.
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Correct Answer is B
Explanation
Choice A rationale
Screening for group B streptococcus B-hemolytic (GBS) is typically performed between 35-37 weeks gestation, not during the initial visit. This screen aims to reduce neonatal GBS infections.
Choice B rationale
A complete physical assessment is necessary during the initial prenatal visit to establish a baseline health status and identify any potential health issues or risk factors in pregnancy.
Choice C rationale
Measuring fundal height is usually done after 20 weeks gestation to assess fetal growth and development, not during the initial prenatal visit, where the focus is on baseline assessments.
Choice D rationale
Performing a urinalysis is part of the initial prenatal visit to screen for urinary tract infections, glucose, protein, and other substances, ensuring maternal and fetal health.
Correct Answer is C
Explanation
Choice A rationale
High-protein, low-carbohydrate diets are not recommended during pregnancy as they can lead to ketone production, which may harm fetal development. A balanced diet is crucial for maternal and fetal health.
Choice B rationale
Although breastfeeding can help with postpartum weight loss, it is not advisable to use pregnancy as a reason to overeat. Healthy weight gain during pregnancy is essential for fetal development.
Choice C rationale
Gaining 1 lb (0.5 kg) per week is recommended during the second trimester for a client with a normal BMI to ensure proper fetal growth and development.
Choice D rationale
Exercise is beneficial, but it cannot prevent all weight gain during pregnancy. Appropriate weight gain is necessary for fetal health and development.
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