A nurse is preparing a client for a Contraction Stress Test (CST).

Which method can be used to induce uterine contractions during the test?

The correct answer is choice D. The client has a history of placenta previa.

Placenta previa is a condition where the placenta covers all or part of the cervix, blocking the baby’s exit from the uterus.

This can cause severe bleeding during pregnancy and delivery and increase the risk of complications for both the mother and the baby.

Therefore, the nurse should report this condition to the provider before performing an amniocentesis.

Choice A is wrong because having Rh-negative blood type is not a contraindication for amniocentesis.

However, the client may need an injection of Rh immunoglobulin after the procedure to prevent Rh sensitization.

Choice B is wrong because having a history of preterm labor is not a contraindication for amniocentesis.

However, the client may need to be monitored closely for signs of preterm labor after the procedure.

Choice C is wrong because having a history of gestational diabetes is not a contraindication for amniocentesis.

However, the client may need to have their blood glucose levels checked before and after the procedure.

Amniocentesis is a diagnostic procedure that involves removing and testing a small sample of amniotic fluid from the uterus for genetic or chromosomal conditions, such as Down syndrome, Edwards syndrome or Patau syndrome.

It can also be used to diagnose fetal infections, treat excess amniotic fluid, or test fetal lung maturity

This is because cramping and vaginal bleeding after an amniocentesis may indicate a possible miscarriage or placental abruption, which can compromise fetal oxygenation and perfusion.

Monitoring fetal heart rate can help detect signs of fetal distress and guide further interventions.

Choice A is wrong because administering Rho(D) immune globulin is indicated for Rh-negative mothers who undergo amniocentesis to prevent isoimmunization, but it is not a priority action in this scenario.

Choice C is wrong because assessing maternal vital signs is important to monitor for signs of infection, hemorrhage, or shock, but it is not as urgent as monitoring fetal well-being.

Choice D is wrong because obtaining an order for an ultrasound exam can help confirm the diagnosis and evaluate the placenta and amniotic fluid, but it is not the first action to take in this situation.