The nurse has received a phone call from a multigravida, who is 21 weeks pregnant and has not felt fetal movement yet. The best action for the nurse to take would be to:
1. Reassure the client that this is a normal finding in multigravidas.
2. Suggest that she should feel for movement with her fingertips.
3. Schedule an appointment for her with her physician for that same day.
4. Tell her gently that her fetus is probably dead.
3
Rationale:
1. Quickening, or the mother's perception of fetal movement, is usually experienced by the pregnant woman at about 18–20 weeks' gestation. Women who have been pregnant previously might feel fetal movement earlier in pregnancy than those who have never been pregnant.
2. Fetal movement can be actively palpated by the client's physician or a trained examiner.
3. Not feeling fetal movement by 21 weeks could indicate that the client's due date is not accurate or that the fetus has died in utero. Fetal movement can be actively palpated by the client's physician or a trained examiner. The woman should be seen as soon as possible.
4. The fetus might have died after or about the 20th week of pregnancy; however, telling the client that the fetus might have died in utero without confirmation of this fact is nontherapeutic.
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