A 28-year-old woman comes in for her first prenatal visit at 8 weeks of gestation.

During the initial visit, the patient states that this is her first pregnancy.

She reports no significant medical history but mentions that she hasn’t had a physical exam in several years.

She denies using alcohol, tobacco, or drugs.

Upon assessment, she appears anxious about the pregnancy, withdrawn, and fearful.

What is the FIRST priority action the nurse should take?

Choice A rationale

A recommended method for fetal kick counts is to choose a time when the baby is most active, often after a meal due to increased maternal glucose levels stimulating fetal activity. The recommended duration is typically 2 hours, during which the client should aim to feel a minimum of 10 movements. This timing provides a reliable snapshot of fetal well-being.

Choice B rationale

Counting fetal movements for only 5 minutes is insufficient to accurately assess fetal well-being and identify potential distress. The standard recommendation is to count movements over a longer period, typically up to 2 hours, to provide a more comprehensive evaluation of fetal activity patterns. A shorter duration may lead to false assurances or missed signs of distress.

Choice C rationale

Recording kicks in a daily log helps establish a baseline pattern of fetal movement specific to that pregnancy. Any significant or sudden decrease from this established baseline, such as fewer than 10 movements in a 2-hour period, is a critical sign that warrants immediate reporting to the healthcare provider for further evaluation and intervention to ensure fetal health.

Choice D rationale

Performing the kick count at the same time each day is crucial for consistency and helps to identify any deviation from the established baseline pattern of fetal activity. Consistency in timing, such as after a specific meal, helps to minimize variables and ensures that the data collected is reliable for monitoring fetal well-being over time.

Choice E rationale

The optimal position for performing fetal kick counts is a reclining or side-lying position, which maximizes blood flow to the uterus and promotes fetal activity. A standing position can compress the vena cava, reducing blood flow to the placenta and potentially decreasing fetal movement, which could lead to an inaccurate or falsely low kick count.

Choice F rationale

Fetal kick counts are generally recommended to begin around the 28th week of gestation. This is when fetal movements become more regular and consistent, making it easier for the client to track a meaningful baseline. Starting the counts earlier at 15 weeks is not useful as the movements are too sporadic and inconsistent for reliable monitoring. *.

Choice A rationale

Fainting and lightheadedness are common, but the education on rising slowly is not relevant for a client on strict bed rest who is not getting out of bed. The priority for this client is education on complications directly related to bed rest.

Choice B rationale

Nasal stuffiness and nosebleeds are common pregnancy symptoms due to increased blood volume and estrogen levels. However, this is not a priority education topic for a client on strict bed rest as it is not directly related to the complications of prolonged immobility.

Choice C rationale

Blood clots are a concern in pregnancy, and bed rest increases this risk. While wearing compression hose is correct, the education on moving around frequently is not possible for a client on strict bed rest and is therefore not a priority education topic.

Choice D rationale

Strict bed rest and the pressure of the gravid uterus can lead to urinary stasis, which significantly increases the risk for bladder infections. Therefore, it is a priority for the nurse to educate the client on emptying their bladder frequently to prevent this common and serious complication. *.