A nurse is educating a client who is 23 weeks pregnant about immunizations.
Which statement should the nurse include in the teaching?

Choice A rationale

A cough and fever in a client at 38 weeks of gestation could indicate an infection, which should be addressed promptly. However, it is not as immediately life-threatening as painless vaginal bleeding at 28 weeks of gestation, which could indicate a serious complication such as placental abruption.

Choice B rationale

Nausea and vomiting at 14 weeks of gestation are common symptoms of early pregnancy and, while uncomfortable, are not usually a sign of a serious problem. This client should be seen, but not before a client with a potentially life-threatening condition like painless vaginal bleeding.

Choice C rationale

Painless vaginal bleeding at 28 weeks of gestation is a serious symptom that could indicate placental abruption, a condition where the placenta detaches from the uterus, which can be life-threatening for both the mother and the baby. This client should be seen first.

Choice D rationale

Vaginal spotting in a client who has missed a period could indicate early pregnancy or a number of other conditions. While this client should be seen to confirm the cause of the spotting, it is not as immediately urgent as painless vaginal bleeding at 28 weeks of gestation.

Based on your last menstrual period (LMP) of May 4, 2022, your estimated date of delivery (EDD) would be around February 11, 2023."

Rationale:

• Calculating the Estimated Date of Delivery (EDD): The EDD can be calculated using Naegele's Rule, which is a standard method used to estimate the due date. The rule involves subtracting three months from the first day of the last menstrual period (LMP), adding seven days, and adjusting the year if necessary.

• Application of Naegele’s Rule:

  • Start with the first day of the LMP: May 4, 2022.
  • Subtract three months: February 4, 2022.
  • Add seven days: February 11, 2022.
  • Since the year needs to be adjusted, the EDD is February 11, 2023.

Key Points:

• Naegele’s Rule is commonly used but assumes a 28-day menstrual cycle and ovulation on the 14th day. Variations in cycle length can affect the accuracy.