Diagnostic Testing/ Second Trimester 14-26 weeks

Question 1

Ammiocentesis

Purpose: (3)

Answer 1

Purpose: To determine
Genetic disorders
Metabolic defects
Fetal lung maturity

Question 2

Ammiocentesis: Risks: (6)

Answer 2

Risks: 
Maternal Hemorrhage
Infection
Rh isoimmunization
Abruptio placentae
Amniotic fluid emboli
Premature rupture of membranes

Question 3

Alpha-fetoprotein (AFP)

1) Purpose:
2) How is this done?
3) When is this done?

Answer 3

Purpose:

1) Assesses the quality of fetal serum proteins
2) Maternal blood sample
3) 16-18 weeks

Question 4

Doppler-Blood flow analysis (umbilical velocimetry)

Purpose:

Answer 4

Purpose: Noninvasive (ultrasonography) method of studying the blood flow in the fetus and placenta

Question 5

Amniocentesis:

Nursing Interventions: (7)

Answer 5

Obtain informed consent
If less than 20 weeks full bladder
If more than 20 weeks empty bladder
Ultrasonography is performed to locate placenta
Baseline vitals and fetal heart rate every 15 minutes
Pt in supine position during procedure
Pt left side after procedure

Question 6

After chorionic villus sampling and amniocentesis instruct the client to notify HCP immediately if the following occurs (7)

Answer 6

Chills
Fever
Bleeding
Leakage of fluid at needle insertion site
Decrease fetal movement
Uterine contractions
Cramping

Question 7

Alpha-Fetoprotein Screening (AFS)

1) Abnormal findings protocol
2) If abnormal levels what is the next procedure?
3) To rule out (2)

4) Abnormal levels can detect ? (2) General (2) Specific

Answer 7

1) Repeat test, false positives are common
2) Ultrasound is performed to rule out
3) Fetal abnormalities
Multiple gestation

4)  Abnormal protein levels can detect
Open neural tube defect
Abdominal wall defects
Spina bifida
Down syndrome

Question 8

Alpha-Fetoprotein Screening (AFS)

1) Low level of AFS indicates?

Answer 8

1) Risk for Down syndrome

Question 9

Alpha-Fetoprotein Screening (AFS)

1) High level of AFS indicates?

Answer 9

1) Risk for neural tube defects

Question 10

Higher levels of hCG and Inhibin-A may indicate?

Answer 10

1) Risk for Down syndrome

Question 11

Lower levels of estriol may indicate?

Answer 11

1) Risk for Down syndrome

Question 12

Estriol (part of Quad Marker Screening)

Answer 12

A protein produced by the fetus and placenta

Question 13

Inhibin A (part of Quad Marker Screening)

Answer 13

A protein produced by the ovaries and placenta

Question 14

Human chorionic gonadotropin (hCG) (part of Quad Marker Screening)

Answer 14

A hormone produced by the placenta

Question 15

Quad Marker and Alpha-Fetoprotein (AFP) Screening

What is the purpose?..to determine?

Answer 15

Ascertains info about the likelihood of the defects. It does not diagnose the actual defect. It may be performed instead of AFP.