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?

"It is a screening test for spinal defects in the fetus."

The MSAFP test is a blood test that measures the amount of alpha-fetoprotein (AFP) in the mother’s blood.

AFP is a protein produced by the baby during pregnancy.The test helps to assess the baby’s risk of certain birth defects, such as neural tube defects, which are abnormalities in the development of the brain and spine.

A. “It is a diagnostic test for spinal defects in the fetus.” This statement is wrong because the MSAFP test is not a diagnostic test.

It only indicates the probability of having a spinal defect, but it does not confirm or rule out the condition.A diagnostic test, such as an ultrasound or amniocentesis, is needed to make a definitive diagnosis.

C. “It is a diagnostic test for chromosomal abnormalities in the fetus.” This statement is wrong because the MSAFP test is not a diagnostic test for chromosomal abnormalities either.

It only indicates the probability of having a chromosomal abnormality, such as Down syndrome, but it does not confirm or rule out the condition.A diagnostic test, such as a chorionic villus sampling (CVS) or amniocentesis, is needed to make a definitive diagnosis.

D. “It is a screening test for chromosomal abnormalities in the fetus.” This statement is partially correct, but not the best answer.

The MSAFP test alone is not very accurate for screening chromosomal abnormalities.It is usually combined with other blood tests and an ultrasound to form a more reliable screening test called a quad screen or an integrated screen.

The normal range of MSAFP levels varies depending on the gestational age of the baby and the laboratory methods used.Generally, the MSAFP levels increase until about 15 weeks of pregnancy and then decrease until delivery.The average MSAFP level at 15 weeks of pregnancy is about 38 ng/mL.However, different laboratories may have different reference ranges, so it is important to consult your healthcare provider for your specific results and interpretation.

. The client’s cervix is dilated.

This indicates that the client may be in preterm labor, which is a contraindication for amniocentesis.

Amniocentesis is a procedure that involves inserting a needle into the amniotic sac to obtain a sample of amniotic fluid for genetic testing or other purposes.

It is usually performed between 15 and 20 weeks of gestation.

Choice A is wrong because the client’s bladder should be full for amniocentesis.

This helps to push the uterus upward and away from the bladder, reducing the risk of injury and making it easier to visualize the fetus and the needle.

Choice B is wrong because the client’s uterus should be above the symphysis pubis at 16 weeks of gestation.

This is a normal finding and does not affect the procedure.

Choice D is wrong because the client’s fundal height should measure around 16 cm at 16 weeks of gestation.

A fundal height of 20 cm may indicate a large for gestational age fetus, multiple gestation, or polyhydramnios (excess amniotic fluid), but these are not absolute contraindications for amniocentesis.

However, they may require further evaluation and adjustment of the technique.