An 18-week pregnant client was informed this morning that she has an elevated alpha-fetoprotein (AFP) level. After the healthcare provider leaves the room, the client asks about the next steps.
What should the nurse advise?

Choice A rationale

While episodes of headache and irritability can occur as side effects of metformin and menotropins, they are not typically severe enough to warrant immediate reporting.

Choice B rationale

Persistent daytime fatigue can be a side effect of these medications, but it is also a common symptom in pregnancy and is not typically a cause for immediate concern.

Choice C rationale

Nausea and vomiting can occur as side effects of these medications. However, they are common side effects and are not typically a cause for immediate concern unless they are severe or persistent.

Choice D rationale

A rapid increase in abdominal girth can be a sign of ovarian hyperstimulation syndrome, a rare but potentially serious side effect of fertility treatments. This condition can cause rapid weight gain, abdominal pain, and bloating, and should be reported immediately.

Choice A rationale

While monitoring the client’s vital signs is an important part of postpartum care, it would not directly address the issue of a boggy uterus that is displaced above and to the right of the umbilicus.

Choice B rationale

Notifying the healthcare provider is important, but it would not be the first action to take. The nurse should first attempt to address the issue.

Choice C rationale

Inspecting the perineal pad could provide information about the client’s postpartum bleeding, but it would not directly address the issue of a boggy uterus that is displaced above and to the right of the umbilicus.

Choice D rationale

Encouraging the client to void is the correct action. A full bladder can displace the uterus, preventing it from contracting properly. By emptying the bladder, the uterus may be able to contract and return to its normal position.