A nurse is teaching a client who is at 15 weeks of gestation and is to undergo an amniocentesis. The nurse should explain that the purpose of this test is to identify which of the following conditions? (Select all that apply.)

Explanation:

A. Congenital heart defects:

Smoking during pregnancy has been linked to an increased risk of congenital heart defects in newborns. Maternal smoking can affect the development of the baby's heart, leading to structural abnormalities in the heart's formation. These defects can range from mild to severe and may require medical intervention after birth.

B. Hearing loss:

Although there is some evidence suggesting a possible association between maternal smoking and hearing problems in children, the link is not as well-established as other complications such as intrauterine growth restriction or congenital heart defects. More research is needed to confirm the direct impact of maternal smoking on hearing loss in newborns.

C. Type 1 diabetes mellitus:

Maternal smoking during pregnancy is not directly linked to an increased risk of Type 1 diabetes mellitus in newborns. Type 1 diabetes is an autoimmune condition that is not typically influenced by maternal smoking during pregnancy.

D. Intrauterine growth restriction (IUGR):

This is the correct choice. Smoking during pregnancy is a well-known risk factor for intrauterine growth restriction (IUGR). It can lead to inadequate fetal growth and lower birth weight than expected for gestational age due to restricted oxygen and nutrient supply to the fetus. Babies born with IUGR may experience various health issues and developmental challenges.

Explanation:

A. "This is a probable sign of pregnancy."

A probable sign of pregnancy is an objective finding observed by a healthcare provider that suggests the likelihood of pregnancy but does not confirm it definitively. Examples of probable signs include positive pregnancy tests (urine or blood tests), changes in the uterus (enlargement, softening), and changes in the cervix (Goodell's sign, Chadwick's sign). Sensations of fetal movement, such as the feeling of the baby moving, are actually presumptive signs of pregnancy rather than probable signs because they can have other explanations and are not definitive proof of pregnancy.

B. "This is a possible sign of pregnancy."

While sensations of fetal movement can be associated with pregnancy, they are more accurately classified as presumptive signs rather than possible signs. Possible signs typically refer to signs or symptoms that could be related to various conditions, including pregnancy, but do not specifically indicate pregnancy on their own. In this context, "possible" may not be as accurate as "presumptive" for describing fetal movement as a sign of pregnancy.

C. "This is a positive sign of pregnancy."

A positive sign of pregnancy is a definitive finding that confirms the presence of a fetus. Examples of positive signs include fetal heartbeat heard by Doppler or ultrasound, fetal movement felt by the healthcare provider (palpation), and visualization of the fetus on ultrasound. Sensations of fetal movement reported by the woman (quickening) are not considered positive signs because they can be subjective and may have other explanations, such as gas or muscle contractions.

D. "This is a presumptive sign of pregnancy."

A presumptive sign of pregnancy is a subjective sign reported by the woman that may indicate pregnancy but can also have other explanations. Examples include amenorrhea (missed periods), nausea and vomiting (morning sickness), breast changes, and sensations of fetal movement (quickening). Sensations of fetal movement are considered presumptive because they are subjective and can be caused by factors other than pregnancy, such as gas or muscle contractions.