A nurse is educating a client who is 23 weeks pregnant about immunizations.
Which statement should the nurse include in the teaching?

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.

Choice A rationale

Anomalies in fetal chromosomes can be identified through amniocentesis. This test involves the extraction of a small amount of amniotic fluid, which contains fetal tissues. The chromosomes of the fetus can be examined for abnormalities.

Choice B rationale

Cephalopelvic disproportion refers to a condition where the mother’s pelvis is too small to allow the baby to pass through the birth canal. This condition cannot be identified through amniocentesis. Amniocentesis is a diagnostic procedure that examines the amniotic fluid (not the maternal pelvis or the size of the fetus) to detect chromosomal abnormalities and certain genetic disorders.

Choice C rationale

Fetal gender can be determined through amniocentesis. The test can identify the presence of Y chromosomes, which would indicate a male fetus.

Choice D rationale

Rh incompatibility is a condition that occurs when a mother is Rh-negative and the baby is Rh-positive. This condition cannot be identified through amniocentesis. Instead, it is typically identified through blood tests of the mother and father.

Choice E rationale

Neural tube defects, such as spina bifida and anencephaly, can be identified through amniocentesis. The test can detect high levels of alpha-fetoprotein, which is often present when a fetus has a neural tube defect.