A nurse is observing fetal breathing movements on an ultrasound for a client who is undergoing a biophysical profile (BPP).

The nurse should document how many points for this variable if the fetus has at least one episode of breathing lasting for 20 seconds within a 30-minute period?

This means that the baby’s heart rate did not slow down after the contractions induced by oxytocin, which is a sign of normal fetal well-being.

A negative CST is normal and desirable.

Choice A is wrong because no contractions were induced during the test.

This means that the test was inconclusive and could not assess the baby’s response to stress.

Choice B is wrong because late decelerations of the FHR were observed with at least 50% of contractions.

This means that the baby’s heart rate slowed down and stayed slow after the contractions, which is a sign of fetal distress and hypoxia.

A positive CST is abnormal and concerning.

Choice D is wrong because the client experienced mild uterine cramping during the test.

This is not a relevant factor for interpreting the CST results, which depend on the FHR patterns.

Uterine cramping can be a side effect of oxytocin administration or nipple stimulation.

"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.