A nurse is caring for a client who has consented to an amniocentesis for genetic cell analysis. The client asks why she can’t have the test before 14 weeks of gestation.
Which of the following responses should the nurse make?
The fetus is not mature enough until this time.
This is when the heartbeat is first audible.
There is not enough amniotic fluid until this time.
The genetic results will not be accurate until this time.
The genetic results will not be accurate until this time.
The Correct Answer is C
Choice A:
While fetal maturity is a factor in the timing of amniocentesis, it's not the primary reason for waiting until 14 weeks.
Earlier in pregnancy, fetal cells are less abundant in the amniotic fluid, making it more challenging to obtain a sufficient sample for accurate testing.
Additionally, the procedure carries a slightly higher risk of miscarriage before 14 weeks.
Choice B:
The audibility of the fetal heartbeat is not directly related to the timing of amniocentesis.
It's typically possible to hear the heartbeat by Doppler ultrasound around 10-12 weeks, but this doesn't mean there's enough amniotic fluid for amniocentesis.
Choice D:
The accuracy of genetic results is not dependent on the timing of amniocentesis after 14 weeks.
As long as a sufficient sample of amniotic fluid is obtained, the accuracy of the results is not affected by gestational age.
Choice C:
The most accurate explanation for why amniocentesis is not performed before 14 weeks is the amount of amniotic fluid. Before 14 weeks, there's typically not enough amniotic fluid to safely extract a sample without potentially harming the fetus or the placenta.
By 14 weeks, there's usually enough fluid to adequately cushion the fetus and the needle during the procedure, reducing the risks involved.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale:
Tachycardia, or a fast heart rate, is not a common finding in severe preeclampsia. While some women with preeclampsia may experience a slight increase in heart rate, it is not typically a significant or defining feature of the condition. In fact, some women with severe preeclampsia may even experience a slightly decreased heart rate due to increased vagal tone.
Choice B rationale:
Hypotension, or low blood pressure, is also not a typical finding in severe preeclampsia. Blood pressure is often elevated in preeclampsia, and it is one of the key diagnostic criteria. Hypotension would be a concerning finding in a woman with preeclampsia, as it could indicate a serious complication such as placental abruption or HELLP syndrome (Hemolysis, Elevated Liver enzymes, and Low Platelet count).
Choice C rationale:
Polyuria, or excessive urination, is not a characteristic finding of severe preeclampsia. In fact, many women with preeclampsia experience oliguria, or decreased urine output, due to decreased kidney function. This is because preeclampsia can cause damage to the blood vessels in the kidneys, impairing their ability to filter blood and produce urine.
Choice D rationale:
Headache is a common and often severe symptom of severe preeclampsia. It is thought to be caused by increased pressure within the brain due to swelling and vasoconstriction of the blood vessels. Headaches in preeclampsia can be very intense and may be accompanied by other symptoms such as blurred vision, nausea, and vomiting. They are often a sign that the preeclampsia is worsening and that delivery may be necessary.
Correct Answer is E
Explanation
Choice A rationale:
Placenta previa is a condition in which the placenta covers all or part of the cervix. It's a serious complication that can cause heavy bleeding during pregnancy and childbirth. However, it's not a direct complication of maternal gestational diabetes.
Choice B rationale:
Newborn hypoglycemia is a condition in which a newborn's blood sugar levels are too low. It can occur in infants of mothers with gestational diabetes, but it's not the most common or significant complication associated with the condition.
Choice C rationale:
Oligohydramnios is a condition characterized by a low amount of amniotic fluid around the baby. It can be associated with maternal gestational diabetes, but it's not as common as other complications, such as macrosomia (large for gestational age baby).
Choice D rationale:
Small for gestational age (SGA) newborn refers to a baby who is smaller than expected for their gestational age. It can be caused by several factors, including restricted intrauterine growth, which can be associated with maternal gestational diabetes. However, it's not the most direct or common complication of the condition.
Choice E rationale:
Maternal gestational diabetes is a condition in which a woman develops high blood sugar levels during pregnancy. It's the most common metabolic complication of pregnancy and can lead to several serious health risks for both the mother and baby. These risks include:
Macrosomia (large for gestational age baby): High blood sugar levels in the mother can cause the baby to grow excessively large, leading to complications during labor and delivery, such as shoulder dystocia, birth injuries, and cesarean delivery. Preeclampsia: Gestational diabetes increases the risk of preeclampsia, a serious condition characterized by high blood pressure and protein in the urine. It can affect multiple organs, including the liver and kidneys, and can be life-threatening for both mother and baby.
Premature birth: Women with gestational diabetes are more likely to deliver their babies prematurely, which can lead to health problems for the baby, such as respiratory distress syndrome, feeding difficulties, and developmental delays.
Neonatal hypoglycemia: Newborns of mothers with gestational diabetes are at increased risk of hypoglycemia (low blood sugar) after birth due to the sudden withdrawal of maternal glucose supply. This can cause seizures, brain damage, and even death if not promptly treated.
Type 2 diabetes later in life: Both mother and child are at increased risk of developing type 2 diabetes later in life.
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