A nurse is preparing a client who is at 10 weeks of gestation for an ultrasound procedure.
Which of the following statements should the nurse make?
"With this procedure, we will be able to determine the biological sex of your fetus.”.
"With this procedure, we will be able to detect congenital anomalies.”.
"This procedure will help in determining your expected delivery date.”.
"This procedure will determine if you have enough amniotic fluid.”.
The Correct Answer is C
Choice A rationale
At 10 weeks of gestation, the external genitalia of the fetus are not yet fully differentiated or large enough to be reliably visualized and identified as male or female on an ultrasound. Fetal sex determination is typically more accurate later in pregnancy, usually after 16-20 weeks, when anatomical structures are more developed and distinct.
Choice B rationale
While some major structural congenital anomalies might be detectable at 10 weeks, a comprehensive and detailed assessment for a wide range of congenital anomalies is usually performed during the anomaly scan, which is typically conducted between 18 and 22 weeks of gestation. Fetal development is still ongoing at 10 weeks.
Choice C rationale
An ultrasound performed in the first trimester, particularly around 10 weeks, is highly accurate for estimating gestational age and, consequently, the expected delivery date. This is because fetal growth is very consistent during this period, allowing for precise measurements such as crown-rump length to determine gestational age within a small margin of error.
Choice D rationale
Assessment of amniotic fluid volume, often quantified using the amniotic fluid index (AFI) or deepest vertical pocket, is more commonly performed in the second and third trimesters of pregnancy. At 10 weeks, the amniotic fluid volume is relatively small, and its adequacy is not typically a primary focus of an early ultrasound unless there are specific concerns.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is {"A":{"answers":"B"},"B":{"answers":"A,B"},"C":{"answers":"A"},"D":{"answers":"A,B"}}
Explanation
Abruptio Placentae: Typically does not cause increased contraction frequency; contractions may be normal or decreased due to uterine irritation or pain.
Uterine Tachysystole: Characterized by more than 5 contractions in 10 minutes averaged over 30 minutes, indicating excessive contraction frequency, which can reduce uteroplacental perfusion.
Uterine Tone
Abruptio Placentae: The uterus often becomes firm, rigid, and tender due to bleeding and inflammation caused by premature placental separation, increasing baseline uterine tone.
Uterine Tachysystole: Uterine tone is elevated because contractions are prolonged and close together, causing the uterus to remain tense with insufficient relaxation.
Pain Report
Abruptio Placentae: Patients usually report sharp, severe abdominal or back pain due to the sudden placental detachment and uterine irritation.
Uterine Tachysystole: Pain may be present but is typically related to frequent contractions rather than sharp, localized pain.
FHR Pattern
Abruptio Placentae: Commonly causes fetal heart rate abnormalities like late decelerations, bradycardia, or absent variability due to fetal hypoxia from compromised placental perfusion.
Uterine Tachysystole: Can cause decreased fetal heart rate variability and late decelerations because frequent contractions reduce oxygen delivery during inadequate relaxation.
Correct Answer is A
Explanation
Choice A rationale
Late decelerations indicate uteroplacental insufficiency, meaning reduced blood flow and oxygen to the fetus. Placing the client in a lateral position (left or right side) can alleviate pressure on the vena cava, improving venous return to the heart, thus increasing cardiac output and uteroplacental perfusion. This is the least invasive initial intervention.
Choice B rationale
While intravenous fluid administration may be indicated in some cases to improve maternal hydration and placental perfusion, repositioning the client is a more immediate and less invasive intervention to address uteroplacental insufficiency by optimizing maternal circulation and oxygen delivery to the fetus.
Choice C rationale
Preparing for a cesarean birth is a significant intervention reserved for persistent or severe fetal distress that does not respond to less invasive measures. Although late decelerations are concerning, immediate surgical intervention is not the first step without attempting to optimize fetal well-being through maternal repositioning.
Choice D rationale
Elevating the client's legs might slightly increase venous return, but it is not the primary intervention for late decelerations. The lateral position is more effective in relieving aortocaval compression, directly addressing the underlying issue of reduced placental blood flow, and is the established first-line intervention.
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