When supporting a family with a fetus diagnosed with anencephaly, what is the most appropriate initial nursing action?

• A. Ensure attachment measures are offered
• B. Prepare to cope with imminent death
• C. Inform about corrective surgical procedures
• D. Provide emotional support for organ donation

Answer: (B)

When a fetus is diagnosed with anencephaly, the immediate nursing focus is on helping the family cope with an imminent loss. This situation carries a prognosis that is not survivable, so the most appropriate first action is to provide honest, compassionate support and help the family prepare for what lies ahead—whether that involves ongoing pregnancy management, the birth process, or end-of-life considerations. The nurse helps the family understand the reality, answers questions, and offers resources (social work, chaplaincy, counseling) to support anticipatory grieving and decision-making.

There are no corrective surgical options to offer for anencephaly, so discussing corrective procedures isn’t appropriate as an initial step. While attachment and bonding have value, they are not the priority when the focus is preparing for an expected death. Organ donation discussions aren’t the immediate nursing action in this context either and would be considered only later if relevant and desired by the family.