A nurse in a prenatal clinic is caring for a client who asks what her estimated date of delivery will be if her last menstrual period was May 4, 2022.
Which of the following is the appropriate response by the nurse?

Choice A rationale

While determining the viability of the fetus is an important aspect of prenatal care, it is not the primary purpose of an ultrasound in this scenario. The client’s report of feeling the baby moving suggests that the fetus is likely viable.

Choice B rationale

The primary purpose of the ultrasound in this scenario is to locate the placenta. Heavy, red vaginal bleeding at 38 weeks of gestation could indicate a complication such as placenta previa, where the placenta covers the cervix. An ultrasound can help confirm this diagnosis.

Choice C rationale

Measuring the biparietal diameter is a method used to estimate fetal weight and gestational age. However, in this scenario, the client is already known to be at 38 weeks of gestation, and the sudden onset of heavy, red vaginal bleeding is a more immediate concern.

Choice D rationale

Assessing fetal lung maturity is typically done when there is a risk of preterm delivery. In this scenario, the client is already at 38 weeks of gestation, which is considered full term. The immediate concern is the heavy, red vaginal bleeding.

Choice A rationale

Abdominal pain during pregnancy can be a normal part of the process as the body changes to accommodate the growing baby. However, severe abdominal pain is not normal and could be a sign of a serious condition such as preterm labor or an ectopic pregnancy.

Choice B rationale

Ballottement refers to a medical sign used in the physical examination of a pregnant woman to detect pregnancy. It involves a quick upward pushing against the uterus and feeling for return impact from the fetus. However, it is not a symptom to report during pregnancy.

Choice C rationale

A sudden gush of fluid from the vagina can be a sign of rupture of membranes, which can lead to premature birth if it occurs before 37 weeks of gestation. This is a critical symptom to report as it may indicate that labor is imminent.

Choice D rationale

Vaginal bleeding can be a sign of several serious conditions in pregnancy such as placenta previa or placental abruption. However, light spotting is common in early pregnancy.

Choice E rationale

Quickening refers to the first movement of the fetus felt by the mother, usually between 18 and 25 weeks of gestation. It is not a symptom to report during pregnancy.