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The nurse in a health care clinic is instructing a pregnant client how to perform "kick counts." Which statement by the client indicates a need for further instruction?

A.

"I need to lie flat on my back to perform the procedure."

B.

“If I count fewer than 10 kicks in a 2-hour period, I would count the kicks again over the next 2 hours."

C.

"I need to place my hands on the largest part of my abdomen and concentrate on the fetal movements to count the kicks."

D.

“I will record the number of movements or kicks."

Answer and Explanation

The Correct Answer is A

A. "I need to lie flat on my back to perform the procedure." Lying flat on the back can cause supine hypotension syndrome due to compression of the inferior vena cava. The client should lie on her left side or sit in a comfortable position to improve placental circulation.

B. “If I count fewer than 10 kicks in a 2-hour period, I would count the kicks again over the next 2 hours." If fewer than 10 movements are felt in 2 hours, the client should rest, eat, and try counting again. If movements remain low, she should contact her provider.

C. "I need to place my hands on the largest part of my abdomen and concentrate on the fetal movements to count the kicks." Placing hands on the abdomen helps the client feel subtle fetal movements.

D. “I will record the number of movements or kicks." Keeping a record of fetal movements helps monitor fetal well-being.


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Related Questions

Correct Answer is B

Explanation

A. "I should schedule the test when the baby is usually active." The test relies on fetal movements to assess heart rate responses, so scheduling it when the baby is active improves accuracy.

B. "I will have to lie on my back during the test." Lying on the back (supine) can cause supine hypotensive syndrome by compressing the inferior vena cava. The client should lie in a semi-Fowler’s or left lateral position.

C. "My baby's heart rate will be monitored during the test." The NST assesses fetal heart rate patterns in response to movement, so monitoring the fetal heart rate is essential.

D. "It will take 20 to 30 minutes to complete the test." An NST typically lasts 20-30 minutes unless additional monitoring is needed due to a nonreactive result.

Correct Answer is B

Explanation

A. Repaglinide: Repaglinide is an oral hypoglycemic agent, but it is not recommended in pregnancy due to limited safety data.

B. Insulin: Insulin is the preferred treatment for gestational diabetes mellitus (GDM) when diet and exercise are insufficient. It does not cross the placenta and is safe for both the mother and fetus.

C. Glipizide: Glipizide is an oral sulfonylurea that crosses the placenta and may cause neonatal hypoglycemia. It is not recommended for GDM.

D. Acarbose: Acarbose is not commonly used in pregnancy due to limited safety data and concerns about gastrointestinal side effects.

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