Which of the following is not a part of the nurse’s role in genetic counseling?

Choice A rationale:

Electrolytes do not consistently improve during the diuretic phase of renal failure. While urine output increases, the kidneys' ability to regulate electrolytes may still be impaired. Electrolyte imbalances, such as hyperkalemia, hyponatremia, and hyperphosphatemia, can persist or even worsen during this phase.

Close monitoring of electrolytes is crucial to guide appropriate interventions, such as electrolyte replacement or restriction.

Choice B rationale:

Urine output (UO) does not remain unchanged during the diuretic phase. It is a defining characteristic of this phase that urine output increases, often significantly. This increase in urine output is a result of the recovering kidney tubules' ability to excrete fluid and waste products.

Choice C rationale:

Urine output (UO) increases in the diuretic phase of renal failure. This is a key feature that distinguishes this phase from the oliguric phase, which is characterized by decreased urine output. The increase in urine output is typically a sign of kidney function recovery. However, it is important to note that the increase in urine output does not necessarily mean that kidney function has fully recovered.

Choice D rationale:

Oxygenation does not typically worsen during the diuretic phase of renal failure. In fact, oxygenation may improve as fluid overload is resolved and pulmonary edema decreases. However, patients with underlying respiratory conditions or those who experience rapid fluid shifts may still require respiratory support.

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.