A nurse is caring for a client who has consented to an amniocentesis for genetic cell analysis. The client asks why she can’t have the test before 14 weeks of gestation.
Which of the following responses should the nurse make?

Choice A:
It is incorrect to state that all women will start to feel the baby move at 24 weeks. While this is a common timeframe, the exact timing of when a woman first feels fetal movements, known as quickening, can vary. Some women may feel movement as early as 16 weeks, while others may not feel it until closer to 25 weeks. Factors such as the position of the placenta, the woman's body size, and whether it is her first pregnancy can influence when she first perceives movement.
Choice B:
While the baby's sex is genetically determined at conception, it is not typically visible on ultrasound until around 18-20 weeks of gestation. This is due to the development of the external genitalia, which occurs between 11 and 14 weeks. It is not accurate to state that the sex is always definitively determined by week 8.
Choice D:
Lanugo, the fine hair that covers a fetus's body, is typically present between 14 and 20 weeks of gestation. It starts to disappear around 32-36 weeks, and most babies are born without it. Therefore, it is incorrect to say that lanugo covers the entire body at 36 weeks.
Choice C:
The fetal heartbeat can be detected by a Doppler stethoscope as early as 10-12 weeks of gestation. This is often a reassuring milestone for pregnant women, as it provides audible confirmation of the baby's presence and well-being. It is a common practice for healthcare providers to use a Doppler stethoscope during prenatal visits to assess the fetal heart rate and monitor fetal development.

Choice A rationale:
Fetal movement counts are a simple yet effective tool to monitor fetal well-being in women with preeclampsia. They provide valuable insights into the baby's activity level and can alert the healthcare team to potential concerns early on.
Preeclampsia can compromise placental blood flow, which can lead to decreased fetal movement. By tracking fetal movements daily, the mother can detect any significant changes or reductions in activity, prompting further assessment and intervention if necessary.
Research has shown that regular fetal movement counts can reduce the risk of stillbirth in women with preeclampsia. This is because prompt recognition of decreased fetal movements allows for timely interventions, such as closer monitoring, induction of labor, or delivery, to prevent adverse outcomes.
Daily fetal movement counts empower women to take an active role in their pregnancy care and contribute to a sense of control in a condition that can often feel unpredictable. This increased involvement can promote maternal-fetal bonding and reduce anxiety.
Choice B rationale:
While fluid restriction has been a traditional recommendation for preeclampsia, current evidence does not support limiting fluid intake to 1,000 ml/day. In fact, excessive fluid restriction can lead to dehydration, which can worsen placental perfusion and compromise fetal well-being.
It's essential for women with preeclampsia to maintain adequate hydration to support essential bodily functions and fetal growth. Adequate fluid intake also helps to prevent urinary tract infections, which are more common in women with preeclampsia.
Choice C rationale:
Although reducing sodium intake can be beneficial for overall blood pressure control, there's insufficient evidence to support a strict sodium restriction of 2,000 mg/day specifically for managing mild preeclampsia. Individual needs may vary, and a more moderate approach to sodium reduction is often recommended.
Focusing on a balanced, healthy diet with appropriate sodium intake is generally more effective than strict limitations. This approach promotes overall well-being and supports healthy blood pressure levels without compromising nutritional needs. Choice D rationale:
Rest is often recommended for women with preeclampsia to reduce stress on the cardiovascular system and promote placental blood flow. However, the supine position (lying on the back) is not ideal, as it can further compress the large blood vessels in the abdomen and potentially reduce blood flow to the placenta.
Side-lying positions, particularly the left lateral position, are preferred for women with preeclampsia. These positions help to alleviate pressure on the major blood vessels, enhance blood flow, and improve uteroplacental circulation, which benefits both the mother and the baby.