A nurse is caring for a patient scheduled for a maternal serum alpha-fetoprotein test at 15 weeks of gestation.
Which explanations about this test should the nurse provide to the patient?

Choice A rationale

Bleeding or spotting can accompany implantation. This is a common occurrence and does not necessarily indicate a problem with the pregnancy. It happens when the fertilized egg attaches to the lining of the uterus. Some women may mistake this bleeding for a light period, but it’s a sign of pregnancy.

Choice B rationale

Fertilization typically takes place in the outer third of the fallopian tube. After ovulation, the egg travels down the fallopian tube towards the uterus. If sperm are present in the fallopian tube at this time, fertilization can occur. This is a normal part of the reproductive process.

Choice C rationale

Sperm can remain viable in the woman’s reproductive tract for 2 to 3 days. This means that intercourse does not have to coincide exactly with ovulation in order to achieve pregnancy. The sperm can survive long enough to fertilize the egg when it is released.

Choice D rationale

The statement “Implantation occurs between 2 and 3 weeks after conception” is incorrect and requires intervention by the nurse. Implantation actually occurs about 6-10 days after ovulation, which is less than 2 weeks after conception.

Choice A rationale

While determining the viability of the fetus is an important aspect of prenatal care, it is not the primary purpose of an ultrasound in this scenario. The client’s report of feeling the baby moving suggests that the fetus is likely viable.

Choice B rationale

The primary purpose of the ultrasound in this scenario is to locate the placenta. Heavy, red vaginal bleeding at 38 weeks of gestation could indicate a complication such as placenta previa, where the placenta covers the cervix. An ultrasound can help confirm this diagnosis.

Choice C rationale

Measuring the biparietal diameter is a method used to estimate fetal weight and gestational age. However, in this scenario, the client is already known to be at 38 weeks of gestation, and the sudden onset of heavy, red vaginal bleeding is a more immediate concern.

Choice D rationale

Assessing fetal lung maturity is typically done when there is a risk of preterm delivery. In this scenario, the client is already at 38 weeks of gestation, which is considered full term. The immediate concern is the heavy, red vaginal bleeding.