The nurse is seeing a patient who asks about the accuracy of Nagele's rule. The nurse explains that accuracy can be compromised when: Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply
1. There is a history of regular menses every 28 days.
2. Amenorrhea is present and ovulation occurs with breastfeeding.
3. Oral contraception was discontinued, but no regular menstruation was established.
4. There has been one or months of amenorrhea.
5. There is an accurate date for the last menstrual period.
2,3,4
Rationale 1: A woman with a history of regular periods every 28 days will most likely have an accurate due date calculated by Nagele's rule.
Rationale 2: Nagele's rule is not always accurate for women who have amenorrhea but are ovulating and conceive while breastfeeding.
Rationale 3: Nagele's rule is not always accurate for women who conceive before regular menstruation is established following discontinuation of oral contraceptives or termination of a pregnancy.
Rationale 4: Nagele's rule is not always accurate for women with markedly irregular periods that include one or more months of amenorrhea.
Rationale 5: When there is an accurate date for the last menstrual period, the due date will be accurate using Nagele's rule.
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