You are performing assessments for an obstetric client who is 5 months pregnant with her third child. Which finding would cause you to suspect that the client was at risk?
a. Client states that she doesn't feel any Braxton Hicks contractions like she had in her prior pregnancies.
b. Fundal height is below the umbilicus.
c. Cervical changes, such as Goodell's sign and Chadwick's sign, are present.
d. She has increased vaginal secretions.
ANS: B
Based on gestational age (20 weeks), the fundal height should be at the umbilicus. This finding is abnormal and warrants further investigation about potential risk. With subsequent pregnancies, multiparas may not perceive Braxton Hicks contractions as being evident compared with their initial pregnancy. Cervical changes such as Goodell's and Chadwick's signs should be present and are considered a normal finding. Increased vaginal secretions are normal during pregnancy as a result of increased vascularity.
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