Read the case scenario and Select All That Apply Using your clinical judgment, how should the nurse respond to this patient? Select All the best responses. (Select All that Apply.)

A. Explain that initial fetal movements, known as "quickening," typically occur between 16 and 20 weeks of pregnancy, so she may begin feeling movement soon: Quickening usually begins during this window, with variation depending on maternal factors. At 18 weeks, it is normal for a primigravida not to have felt movement yet, and reassurance is appropriate. B. Inform her that absence of fetal movement at this stage always indicates fetal distress: Fetal distress cannot be determined at 18 weeks based on lack of perceived movement. Many women, especially first-time mothers, do not recognize fetal activity until closer to 20 weeks, so this statement would cause unnecessary alarm. C. Instruct her to immediately come to the hospital for fetal monitoring due to lack of movement at 18 weeks: Immediate monitoring is unnecessary at this gestational age. Fetal movements may not yet be detectable, and intervention is only indicated if movement is absent after 20–22 weeks or if previously felt movements decrease later in pregnancy. D. Advise her to increase hydration and rest in a quiet environment to better detect fetal movement: Resting in a calm setting and ensuring good hydration can make subtle movements easier to perceive. These strategies help the mother tune into early fetal activity without causing anxiety. E. Suggest keeping a daily record of fetal movements starting around 24 weeks to monitor fetal well-being: Kick counts and fetal movement tracking are recommended beginning around 24–28 weeks, once movements become regular and strong enough to monitor consistently. F. Reassure her that first-time mothers often feel fetal movement closer to 20 weeks, which is normal: Primigravidas usually perceive fetal movements later than multiparas because they are less familiar with the sensations. Reassurance at this stage helps reduce anxiety while setting realistic expectations.