A nurse in a prenatal clinic is determining a client's estimated date of delivery using Naegele's rule. The first day of her last menstrual period was May 8. Which of the following dates should the nurse tell the client is her estimated date of delivery?

Choice A:
The umbilicus is typically the location of the fundus at around 20 weeks of gestation, not 22 weeks.
If the fundus is at the umbilicus at 22 weeks, it could indicate that the fetus is not growing at the expected rate. This would warrant further investigation, such as an ultrasound, to assess fetal growth and development.

Choice C:
3 cm below the umbilicus is too low for a 22-week gestation.
This would suggest that the fetus is smaller than expected for the gestational age.
Possible causes of this include incorrect dating of the pregnancy, fetal growth restriction, or oligohydramnios (low amniotic fluid).

Choice D:
5 cm above the umbilicus is too high for a 22-week gestation.
This could indicate that the woman is carrying multiples, has polyhydramnios (excess amniotic fluid), or that the fetus is larger than expected for the gestational age (macrosomia).
Importance of Fundal Height Measurement:
Fundal height measurement is a simple, non-invasive way to assess fetal growth and development during pregnancy. It is typically measured at each prenatal appointment, starting at around 20 weeks of gestation.
By tracking the fundal height over time, healthcare providers can identify potential problems with fetal growth and make necessary interventions.

Choice A:

Mood swings are a common and expected symptom of early pregnancy due to hormonal changes. They typically do not require medical attention unless they become severe or interfere with daily life.
While it's important to discuss mood swings with a healthcare provider, they are not considered a critical symptom that necessitates immediate action.

Choice C:
Urinary frequency, or the need to urinate more often, is also a common symptom of early pregnancy. It's caused by hormonal changes and the growing uterus putting pressure on the bladder.
While it can be inconvenient, it's typically not a cause for concern unless accompanied by other symptoms, such as pain or burning during urination.

Choice D:
Decreased energy, or fatigue, is another common and expected symptom of early pregnancy.
It's often caused by hormonal changes and the body's increased workload to support the growing fetus.
While it can be frustrating, it's typically not a cause for concern unless it becomes severe or interferes with daily life.

Choice B:
Facial edema, or swelling of the face, is not a common symptom of early pregnancy.
It can be a sign of preeclampsia, a serious pregnancy complication characterized by high blood pressure and protein in the urine.
Preeclampsia can develop suddenly and progress quickly, so it's important to seek medical attention right away if facial edema occurs.
Key Points:
Facial edema is a potential sign of preeclampsia, a serious pregnancy complication.
Mood swings, urinary frequency, and decreased energy are common and expected symptoms of early pregnancy that typically do not require immediate medical attention.
It's important for pregnant women to be aware of potential warning signs and to seek medical advice promptly if they experience any concerning symptoms.