A nurse is caring for a client who had an amniocentesis at 16 weeks gestation and reports cramping and vaginal bleeding 24 hours later.

Which of the following actions should the nurse take first?

A low level of AFP (<0.5 MoM) in a pregnant woman can indicate that the fetus has a chromosomal abnormality, such as Down syndrome or Edwards syndrome.

This is because these conditions affect the development of the fetal liver, which produces AFP.

Choice A is wrong because neural tube defects, such as spina bifida, are associated with high levels of AFP (>2.5 MoM) in the maternal blood.

This is because AFP can leak from the open spinal canal of the fetus into the amniotic fluid and then into the maternal blood.

Choice C is wrong because maternal weight-related factors do not affect the level of AFP in the maternal blood.

However, they can affect the interpretation of the AFP test results, as the test needs to be adjusted for maternal weight, age, ethnicity, and gestational age.

Choice D is wrong because fetal demise (death) can also cause high levels of AFP in the maternal blood, as the AFP from the dead fetus can leak into the amniotic fluid and then into the maternal blood.

Normal ranges of AFP in pregnant women vary depending on the gestational age and the method of measurement.

Generally, normal levels of AFP are below 10 ng/ml in nonpregnant adults and below 2.5 MoM in pregnant women.

Each of the five variables in a biophysical profile (BPP) is assigned a score of either 0 or 2 points, depending on whether it meets the criteria or not.

The five variables are:

Fetal breathing: 2 points if there is at least one episode of rhythmic breathing lasting at least 30 seconds within 30 minutes, 0 points otherwise.

Fetal movement: 2 points if there are at least three discrete body or limb movements within 30 minutes, 0 points otherwise.

Fetal tone: 2 points if there is at least one episode of extremity extension and subsequent return to flexion, 0 points otherwise.

Amniotic fluid volume: 2 points if there is a pocket of amniotic fluid measuring at least 2 cm in two perpendicular planes, 0 points otherwise.

Nonstress test: 2 points if there are at least two accelerations of fetal heart rate with or without fetal movement within 20 minutes, 0 points otherwise.

Choice A is wrong because each variable can have a score of either 0 or 2, not 0 or.

Choice C is wrong because there is no score of 1 for any variable.

Choice D is wrong because it is incomplete and does not provide the full range of possible scores.