National Council Licensureination - NCLEX-RN

To calculate the estimated date of confinement (EDC) using Naegele's rule, you start with the first day of the last menstrual period (LMP), subtract 3 months, and then add 7 days to that date, finally adjusting the year if necessary. In this case, the LMP began on May 20. Subtracting 3 months gives us February 20. Adding 7 days results in February 27. Therefore, the estimated date of confinement is February 27.

Nausea and vomiting are common symptoms experienced by many pregnant women during the first trimester. These symptoms are due to elevated levels of human chorionic gonadotropin (hCG) and changes in carbohydrate metabolism.

No amount of alcohol has been determined safe for pregnant women. Alcohol should be avoided due to the risk of fetal alcohol syndrome and other potential developmental issues. Therefore, the safest recommendation is to consume no alcohol during pregnancy.

The nurse should be alert to pregnancy-induced hypertension (PIH) in a 38-year-old pregnant woman. Physical risks for the pregnant client older than 35 include an increased risk for PIH, cesarean delivery, fetal and neonatal mortality, and trisomy. PIH is particularly prevalent in older pregnancies due to age-related changes in vascular health and other physiological factors.

She needs further instruction and reinforcement regarding her diet and weight control. The recommended weight gain during pregnancy should be gradual, with about 12 pounds during the entire second and third trimesters combined. Gaining 10 pounds in just 2 months indicates that she might not be following the dietary guidelines properly. Therefore, she should be re-evaluated, and her dietary habits should be reinforced to ensure healthy weight management during pregnancy. Restrictive diets are generally not recommended during pregnancy as they can potentially harm both the mother and the baby.