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 maternal serum alpha-fetoprotein test is a type of prenatal blood test that measures the levels of MSAFP in the blood of a pregnant person.The test helps the healthcare provider assess the baby’s risk of certain medical conditions, such as neural tube defects and chromosomal abnormalities.The test is usually done between 15 and 20 weeks of pregnancy.

A screening test means that it does not diagnose any health conditions, but only indicates the probability of having them.

A positive test means that the baby has a higher risk of having a birth defect, but it does not confirm it.

A negative test means that the baby has a lower risk of having a birth defect, but it does not rule it out.Further tests are needed to confirm or exclude the diagnosis.

A diagnostic test means that it can provide a definite diagnosis of a health condition.A maternal serum alpha-fetoprotein test is not a diagnostic test for spinal defects or chromosomal abnormalities in the fetus.

Statement A is wrong because it says that the test is a diagnostic test for spinal defects in the fetus, which is not true.

Statement C is wrong because it says that the test is a diagnostic test for chromosomal abnormalities in the fetus, which is not true.

Statement D is wrong because it says that the test is a screening test for chromosomal abnormalities in the fetus, which is only partially true.The test can screen for some chromosomal abnormalities, such as Down syndrome, but not all of them.

The test also screens for neural tube defects, which are not chromosomal abnormalities.

Normal ranges for MSAFP vary depending on the gestational age and the laboratory methods used.Generally, MSAFP levels increase until about 32 weeks of pregnancy and then decrease until delivery.

High levels of MSAFP may indicate neural tube defects, multiple pregnancies, incorrect dating of pregnancy, or other conditions.Low levels of MSAFP may indicate Down syndrome, other chromosomal abnormalities, or other conditions.

The correct answer is choice B. Monitor fetal heart rate.

This is because cramping and vaginal bleeding after amniocentesis are signs of possible complications such as miscarriage, preterm labor, or injury to the fetus.

Monitoring fetal heart rate can help assess the well-being of the fetus and detect any signs of distress.

Choice A is wrong because administering Rho(D) immunoglobulin is only necessary if the mother has Rh-negative blood and the baby has Rh-positive blood, which can cause Rh sensitization.

This is not given routinely to all women who have amniocentesis.

Choice C is wrong because assessing maternal vital signs is not the first priority when there is a risk of fetal compromise.

Maternal vital signs can be affected by many factors and are not specific indicators of fetal health.

Choice D is wrong because obtaining an order for an ultrasound exam is not the first action to take.

An ultrasound exam can help confirm the diagnosis of complications such as placental abruption or fetal demise, but it requires time and equipment that might delay immediate intervention.

Monitoring fetal heart rate can be done quickly and easily at the bedside.