The nurse is assessing a client at 36 weeks gestation during a routine prenatal visit. Which statement by the client should the nurse investigate first?

Question

Quizplus · Accepted Answer

Fetal movement is a sign of fetal health and indicates an intact fetal central nervous system. Fetal movement may occur numerous times per hour during the last trimester of pregnancy, although the client may not perceive every movement. Multiple factors (eg, maternal substance abuse, medications, fasting, fetal sleep) can affect fetal movement. However, fetal movements should not decrease as the fetus increases in size. Decreased fetal movement is a potential warning sign of fetal compromise (ie, impaired oxygenation), which may precede fetal death (Option B). The nurse prioritizes assessment of client reports of decreased fetal movement to evaluate fetal well-being (eg, nonstress test). (Option A) Leg cramps commonly occur in the third trimester, especially at night, due to the weight of the gravid uterus applying pressure to nerves affecting calf muscles. Home interventions include stretching legs, massaging calves, and increasing fluid intake. (Option C) Dependent edema in the lower extremities is common in the third trimester due to decreased venous return (gravid uterus pressure on vena cava), especially with prolonged sitting/standing. This is not a priority over decreased fetal movement. (Option D) As the uterus rises in the third trimester, the diaphragm is prevented from allowing full lung expansion, causing dyspnea, especially with exertion. Educational objective: Fetal movement is a sign of fetal health and represents an intact fetal central nervous system. The nurse should educate clients that fetal movements do not decrease in the late third trimester and prioritize assessment of clients reporting decreased fetal movement.

The Nurse Is Assessing a Client at 36 Weeks Gestation