Which suggestions should the nurse include when teaching about appropriate weight gain in pregnancy? (Select all that apply)

The correct answer is d. Amenorrhea.

Choice A: Chadwick’s sign is a non-specific, early sign of pregnancy that is typically characterized by a bluish discoloration of the cervix, vagina, and vulva. The Chadwick sign can typically be observed as early as six to eight weeks after conception, and commonly disappears shortly after birth. However, it’s not a definitive indication of pregnancy, and the absence of it on physical exam does not exclude a potential pregnancy.

Choice B: Hegar’s sign is a non-specific indication of pregnancy that is characterized by the compressibility and softening of the cervical isthmus (i.e., the portion of the cervix between the uterus and the vaginal portion of the cervix). It typically presents between the fourth and sixth week of pregnancy and may be present until the 12th week of pregnancy. However, the Hegar sign is not a definitive indication of pregnancy, and the absence of it does not exclude a potential pregnancy.

Choice C: A positive pregnancy test By 10 weeks, a home pregnancy test would almost certainly show a positive result if the woman is pregnant. This is because the hormone human chorionic gonadotropin (hCG), which is produced by the placenta after implantation of the embryo into the uterine wall, would be present in high enough levels to be detected by the test. However, a positive pregnancy test is not a presumptive sign of pregnancy, but rather a probable one.

Choice D: Amenorrhea, or the absence of menstrual periods, is often considered the most presumptive sign of pregnancy. This is because it’s one of the first noticeable signs of pregnancy for many women. By 10 weeks of gestation, the woman would likely have missed two menstrual periods if she usually has regular cycles. However, while amenorrhea is a common early sign of pregnancy, it can also be caused by various other conditions or factors such as stress, significant weight loss or gain, or certain medical conditions. Therefore, a missed period should be followed up with a pregnancy test to confirm pregnancy.

Choice A reason: This is incorrect because a donor embryo is not used in IVF-ET. A donor embryo is an embryo that was created from another couple's gametes and donated to an infertile couple. IVF-ET uses the couple's own gametes to create an embryo.

Choice B reason: This is incorrect because it is dismissive and unprofessional. The nurse should respect the husband's curiosity and provide accurate and clear information about the procedure. The nurse should also address any concerns or questions that the couple may have.

Choice C reason: This is correct because it is a concise and accurate description of the IVF-ET procedure. The nurse explains the main steps and the purpose of the procedure in simple terms.

Choice D reason: This is incorrect because donor sperm is not used in IVF-ET. Donor sperm is sperm that was obtained from another man and donated to an infertile couple. IVF-ET uses the husband's own sperm to fertilize the wife's eggs.