A client at 20 weeks gestation reports discomfort after amniocentesis procedure to the nurse. Which of the following assessment findings warrants priority action by the nurse?

Explanation:

A. Braxton Hicks contraction

Braxton Hicks contractions are often referred to as "practice" contractions and are common during pregnancy. They are typically irregular and do not cause cervical changes. While discomfort after an amniocentesis procedure can sometimes trigger Braxton Hicks contractions, they are not usually a cause for immediate concern unless they become frequent, intense, or are accompanied by other signs of preterm labor, such as regular contractions, lower back pain, pelvic pressure, or changes in vaginal discharge.

B. Amniotic fluid contains fetal urine

The presence of fetal urine in the amniotic fluid is a normal and expected process during pregnancy. Fetal urine production contributes to the volume and composition of amniotic fluid, helping maintain the environment in the uterus and supporting fetal development. This finding is not directly related to the client's discomfort after an amniocentesis procedure and is not a cause for immediate concern unless there are other complications or abnormalities related to the amniotic fluid composition.

C. Prolonged vaginal bleeding

Prolonged vaginal bleeding after an amniocentesis procedure is a significant finding that requires immediate attention. While some spotting or mild bleeding can occur after the procedure, prolonged or significant bleeding may indicate complications such as uterine injury, placental abruption, or other issues that need urgent assessment and intervention by healthcare providers.

D. Lab results reveal abnormal chromosome cells

Abnormal chromosome cells found in the amniotic fluid sample obtained during amniocentesis may indicate genetic abnormalities or conditions in the fetus. While this finding is significant and requires follow-up and further evaluation, it is not an immediate concern in terms of the client's discomfort or the need for priority action by the nurse unless it is associated with other urgent clinical signs or symptoms.

Explanation:

A. Limit alcohol consumption:

Alcohol consumption during pregnancy is associated with various risks, including fetal alcohol spectrum disorders (FASDs). However, in the context of reducing the risk of NTDs specifically, the focus is on nutritional factors, particularly folic acid intake, rather than alcohol consumption.

B. Consume foods fortified with folic acid:

This choice is the correct recommendation. Folic acid is crucial for the prevention of neural tube defects. Women of childbearing age, especially those planning pregnancy, are advised to consume foods fortified with folic acid or take folic acid supplements to ensure adequate intake before and during early pregnancy. This is a key preventive measure endorsed by healthcare professionals worldwide.

C. Increase intake of iron-rich foods:

Iron is important during pregnancy to prevent anemia and support fetal growth and development. However, iron intake is not directly linked to reducing the risk of neural tube defects. While overall nutritional health is essential during pregnancy, focusing on iron-rich foods alone does not specifically address the prevention of NTDs.

D. Avoid foods containing aspartame:

Aspartame is an artificial sweetener found in many foods and beverages. While there may be general recommendations regarding artificial sweetener consumption during pregnancy, avoiding foods with aspartame is not directly related to reducing the risk of neural tube defects. The primary focus for NTD prevention lies in adequate folic acid intake.