Final answer:
If a client at 38 weeks of gestation reports no fetal movement for 24 hours, a nurse should perform a kick count, palpate the uterus for movements, and report to the healthcare provider for further tests like a non-stress test or ultrasound to assess fetal well-being.
Step-by-step explanation:
If a client who is at 38 weeks of gestation reports no fetal movement for the past 24 hours, the nurse should initially ask the client to lie on her left side and try to count any fetal movements, a process known as a kick count. If no movement is detected, the nurse should then proceed with palpating the uterus to feel for any subtle movements or responses from the fetus. It is important to document all findings and report them to the healthcare provider promptly. The provider may order additional tests such as a non-stress test or a biophysical profile to assess the well-being of the fetus. Immediate medical attention is vital as decreased fetal movement could indicate potential complications such as fetal distress.
Additional Monitoring and Tests
Depending on the initial assessment, more sophisticated monitoring may be required. An ultrasound may be performed to visualize fetal movements, check for amniotic fluid levels, and ensure the fetus is receiving adequate oxygen and nutrients. In some cases, fetal heart monitoring is done to assess the fetus's heart rate pattern. These evaluations help to ensure the safety of the fetus and assist in making decisions about the management of the pregnancy, including possible early delivery.