A nurse is performing an assessment on a client seen in the health care clinic for a first prenatal visit. The nurse asks the client when the first day of the last menstrual period (LMP) was and the client reports February 9, 2013. Using Naegele's rule, the nurse determines that the estimated date of birth is?

Appeared in: DHS Staff Nurse - 2018 (Shift-2nd)

Explanation

Naegele's rule is a standard formula used to estimate a pregnant woman's due date based on her last menstrual period (LMP).
The rule involves adding 7 days to the first day of the LMP and then adding 9 calendar months.
Alternatively, one can subtract 3 months from the LMP, add 7 days, and then add 1 year.
For an LMP of February 9, 2013, adding 9 months and 7 days results in an estimated date of birth of November 16, 2013.

Option A: This option is incorrect in both the month and the day. It likely results from a significant error in applying Naegele's rule, such as subtracting 4 months and 2 days.
Option B: This option has the correct day but an incorrect month. This error typically occurs when subtracting 4 months from the LMP month instead of the correct 3 months.
Option C: This option has the correct month but an incorrect day. This error occurs when the 9 months are correctly added (or 3 months subtracted) but the step of adding 7 days to the date is forgotten.

Clinical Relevance

Nursing practice connection: Use the key finding related to Calculating Estimated Date of Birth (EDB) using Naegele's Rule to guide bedside assessment, documentation, and the next nursing action.
Accurate calculation of the estimated date of birth is crucial for timing prenatal screenings (e.g., for aneuploidy), monitoring fetal growth, and planning for delivery.
Nurses play a key role in educating clients that Naegele's rule provides an estimate. The actual delivery can occur up to two weeks before or after this date.
The accuracy of Naegele's rule depends on the woman having a regular 28-day menstrual cycle. It is less reliable for women with irregular cycles.

How to Approach the Question

Identify the core task from the question: Calculate the estimated date of birth (EDB).
Extract the key piece of information provided: The first day of the last menstrual period (LMP) is February 9, 2013.
Recall the formula for Naegele's rule: LMP + 9 months + 7 days.
Apply the formula step-by-step. First, add 7 days to the date: 9 + 7 = 16.
Next, add 9 months to the month: February + 9 months = November.
Combine the results to get the final date: November 16, 2013.

Concept Tested & Keywords

Concept Tested: Calculating Estimated Date of Birth (EDB) using Naegele's Rule
Stem keywords: prenatal visit, last menstrual period, LMP, February 9, 2013, Naegele's rule, estimated date of birth
Lead-in keywords: determines that
Negative lead-in flag: false

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E6 Comprehensive Textbook of Community Health Nursing for BSc Nursing Students Part 2 — Subpart A (pp 1-275 of 550) p. 195-197

E6 Obstetrics Williams p. 72-94

Practise the full DHS Staff Nurse - 2018 (Shift-2nd)

Attempt every question from this paper in a timed mock, then review the full solution for each one.