A nurse is providing education to a client who is scheduled to undergo chorionic villus sampling (CVS).
Which statement by the client indicates an understanding of this test?
“This test can detect neural tube defects.”.
“This test can detect genetic disorders.”.
“This test can detect chromosomal abnormalities.”.
“This test can detect Rh sensitization.”.
The Correct Answer is B
This test can detect genetic disorders.
Chorionic villus sampling (CVS) is a prenatal test that involves taking a sample of tissue from the placenta to test for chromosomal abnormalities and certain other genetic problems.
The placenta is a structure in the uterus that provides blood and nutrients from the mother to the fetus.
Choice A is wrong because CVS does not provide information on neural tube defects, such as spina bifida.
For this reason, women who undergo CVS also need a follow-up blood test between 16 to 18 weeks of their pregnancy to screen for neural tube defects.
Choice C is wrong because CVS can detect chromosomal abnormalities, but not all chromosomal abnormalities are genetic disorders.
For example, Down syndrome is a chromosomal abnormality caused by an extra copy of chromosome 21, but it is not inherited from the parents.
Choice D is wrong because CVS cannot detect Rh sensitization, which is a condition where the mother’s immune system produces antibodies against the fetus’s blood type.
Rh sensitization can be detected by a blood test that measures the level of antibodies in the mother’s blood.
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Correct Answer is D
Explanation
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
Correct Answer is C
Explanation
. The client’s cervix is dilated.
This indicates that the client may be in preterm labor, which is a contraindication for amniocentesis.
Amniocentesis is a procedure that involves inserting a needle into the amniotic sac to obtain a sample of amniotic fluid for genetic testing or other purposes.
It is usually performed between 15 and 20 weeks of gestation.
Choice A is wrong because the client’s bladder should be full for amniocentesis.
This helps to push the uterus upward and away from the bladder, reducing the risk of injury and making it easier to visualize the fetus and the needle.
Choice B is wrong because the client’s uterus should be above the symphysis pubis at 16 weeks of gestation.
This is a normal finding and does not affect the procedure.
Choice D is wrong because the client’s fundal height should measure around 16 cm at 16 weeks of gestation.
A fundal height of 20 cm may indicate a large for gestational age fetus, multiple gestation, or polyhydramnios (excess amniotic fluid), but these are not absolute contraindications for amniocentesis.
However, they may require further evaluation and adjustment of the technique.
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