A nurse in an obstetrics office is reviewing a client’s medical record. The client is a 28-year-old female at 24 weeks gestation.

Exhibits

For each client finding, click to specify if the finding is a biophysical, psychosocial, or environmental risk factor that increases the client’s risk for pregnancy complications. There must be at least 1 selection in every row. There does not need to be a selection in every column.

Choice A rationale

Thickening of the uterine lining is not characteristic of gestational trophoblastic disease (GTD). Instead, GTD involves abnormal growth of trophoblast cells, which form part of the placenta, leading to its distinct appearance.

Choice B rationale

Enlargement of the fallopian tubes is not associated with GTD. GTD involves abnormal placental development rather than tubal changes. Ultrasound imaging reveals characteristic findings in the placenta.

Choice C rationale

GTD's hallmark ultrasound finding is grape-like clusters in the placenta, indicative of molar pregnancy. This appearance results from the proliferation of abnormal trophoblast cells and hydropic villi.

Choice D rationale

Multiple cysts in the ovaries are not characteristic of GTD. This description may relate to polycystic ovary syndrome (PCOS) but does not align with GTD’s specific ultrasound findings involving the placenta.

Choice A rationale

Anemia in pregnancy requires increased iron intake to support hemoglobin production, essential for oxygen transport in the blood. Iron-rich foods, such as red meat and leafy greens, are recommended.

Choice B rationale

Decreasing protein intake is counterproductive for anemic pregnant clients. Protein is vital for overall health and fetal development, and adequate intake should be maintained.

Choice C rationale

Calcium-rich foods are important but do not directly address anemia. They support bone health, and while necessary, they do not substitute the need for increased iron in anemic clients.

Choice D rationale

Vitamin C intake should be increased alongside iron-rich foods as it enhances iron absorption. However, increasing vitamin C alone does not suffice to correct anemia without adequate iron intake.