A nurse is caring for a client who has oligohydramnios and is undergoing a biophysical profile (BPP).

The nurse should expect to see which of the following findings on the ultrasound?

The correct answer is choice A. Notify the health care provider immediately.

This is because cramping and vaginal bleeding 24 hours after amniocentesis are signs of possible complications, such as injury to the baby or mother, leaking of amniotic fluid, infection, Rh sensitization, preterm labor, or miscarriage.

These complications are rare, but they can be serious and require immediate medical attention.

Choice B is wrong because administering pain medication to the patient does not address the underlying cause of the cramping and bleeding, and may delay seeking help.

Choice C is wrong because encouraging the patient to rest and elevate her legs may not prevent further complications, and may also delay seeking help.

Choice D is wrong because offering emotional support and reassurance to the patient is not enough to ensure the safety of the baby and the mother, and may give a false sense of security.

Normal ranges for amniocentesis are:

No chromosomal defects detected in the fetus and no abnormal proteins present in amniotic fluid

No signs of infection or other illness in the baby

Fetal lungs mature enough for birth if delivery is planned sooner than 39 weeks

"NST is performed after 28 weeks of gestation or earlier if there are risk factors."12 This statement indicates that the client understands when and why an NST is done.

Choice B is wrong because it describes a reactive NST, not a nonreactive one.

A reactive NST means that the fetal heart rate increases by at least 15 beats per minute for at least 15 seconds twice or more in a 20-minute period.2

Choice C is wrong because it confuses NST with contraction stress test (CST), which requires monitoring uterine contractions.

NST does not involve contractions.2

Choice D is wrong because it describes possible causes of a nonreactive NST, not a reactive one.

A nonreactive NST may indicate fetal hypoxia, distress, sleep, medication effect, or neurological abnormality.2