A nurse is caring for a client who is at 32 weeks of gestation and is in labor. Which of the following medications is contraindicated for this client?

Choice A rationale:
Primipara refers to a woman who is giving birth for the first time. While being a primipara may have some implications for the birthing process, it is not a cause of the newborn being small for gestational age.
Choice B rationale:
Maternal obesity may have various effects on pregnancy, but it is not specifically a direct cause of the newborn being small for gestational age.
Choice C rationale:
Perinatal asphyxia refers to a lack of oxygen or oxygen deprivation around the time of birth. While this can lead to various health issues for the newborn, it is not a primary cause of being small for gestational age.
Choice D rationale:
Placental insufficiency occurs when the placenta does not function adequately to provide sufficient oxygen and nutrients to the developing fetus. This can result in the newborn being small for gestational age due to restricted growth in the womb.

Choice A rationale: The gender of the fetus is not determined through amniocentesis. Fetal gender determination can be achieved through ultrasound or other specialized genetic tests if needed.
Choice B rationale: While amniocentesis can provide information about certain chromosomal abnormalities and genetic conditions, it is not the primary procedure used to detect anatomic abnormalities. Detailed ultrasound and other specialized imaging techniques are used for this purpose.
Choice C rationale: Amniocentesis is a prenatal diagnostic procedure in which a small amount of amniotic fluid is withdrawn from the uterus. The amniotic fluid contains fetal cells and biochemical substances that can provide valuable information about the fetus's health and development. One of the essential pieces of information obtained from amniocentesis is the maturity of the lungs. This is crucial in preterm labor to assess whether the lungs are mature enough to support breathing if the baby is born prematurely.
Choice D rationale: The gestational age is determined through other methods, such as ultrasound measurements and the last menstrual period. Amniocentesis is not primarily used to determine the weeks of gestation.