A pregnant client is undergoing a quad screen test and inquires about the possible results.
Which of the following responses is most appropriate?

Rationale for Choice A:

Administering oxygen via a mask or nasal cannula is the most appropriate nursing intervention in this situation. Here's a detailed explanation:

1. Addresses Hypoxia: The client's symptoms of lightheadedness, dizziness, and tingling fingers strongly suggest hyperventilation, which can lead to hypoxemia (low blood oxygen levels). Administering oxygen directly increases the concentration of oxygen in the client's bloodstream, rapidly addressing the hypoxia and its associated symptoms.
2. Promotes Calmness: Oxygen therapy can also have a calming effect, which can help to slow the client's breathing rate and further improve oxygenation. This is crucial during the transition phase of labor, as anxiety and stress can exacerbate hyperventilation.
3. Supports Fetal Oxygenation: Ensuring adequate maternal oxygenation is essential for fetal well-being. By providing oxygen to the mother, the nurse is also indirectly supporting the oxygen supply to the fetus.

Rationale for Choice B:

Telling the client to breathe at a normal rate is not an effective intervention for hyperventilation. It's often challenging for a client experiencing hyperventilation to control their breathing rate on command. This approach can also increase anxiety, potentially worsening the hyperventilation.

Rationale for Choice C:

While notifying the physician is important to keep them informed of the client's status, it's not the immediate priority in this situation. The nurse can independently initiate oxygen therapy to address the client's hypoxia and improve her condition. The physician can then be consulted for further guidance or interventions if needed.

Rationale for Choice D:

Instructing the client to breathe into her cupped hands is a technique that can sometimes help to slow breathing and increase carbon dioxide levels. However, it's not as effective as administering oxygen in addressing the underlying hypoxia and may not provide sufficient relief for the client's symptoms.

Choice C rationale:

It is a misconception that fetal movement decreases as delivery approaches. While the nature of the movements may change— becoming less like kicks and more like rolls or twists due to less space in the uterus—the frequency of movements should remain consistent. In fact, increased fetal movement can be a sign of labor approaching. Therefore, a pregnant client who believes that fetal movements will decrease closer to delivery needs further instruction to ensure they are aware of this important health indicator.

Here's a detailed explanation of why the other choices are correct:

Choice A: This statement is correct. Fetal kick counts can be performed at home, providing a convenient and comfortable way to monitor fetal well-being.

Choice B: This statement is also correct. A decrease in fetal movement, defined as less than 3 kicks in an hour, is a potential concern and warrants contacting a healthcare provider for further evaluation.

Choice D: This statement is accurate as well. Daily fetal kick counts are generally recommended to establish a baseline of the baby's usual activity pattern and to detect any significant changes that might indicate a problem.