Module 4 - Fetal Assessment Objectives (Exam 2) 1

Question 1

Purpose and nursing responsibilites associated with Multiple Marker Test

Answer 1

1. Optional screening test of mother’s serum
2. Performed at 15 to 21 weeks of gestation
3. Alpha-fetoprotein, human chorionic gonadotropin, unconjugated estriol, and inhibin A are included
4. High false-positive rate
5. Elevated AFP may indicated neural tube or body wall defects, multiple gestation, or a later gestational age than is currently estimated
6. Low AFP level could indicate an increased risk of trisomy 18 or 21
7. Elevated Inhibin A levels and low UE could also mean downsyndrome
8. Abonormal results may indicate a need for a repeated test, then an ultrasound or amniocentesis

Question 2

Purpose and nursing responsibilites associated with Ultrasound

Answer 2

• Uses sound waves to produce images of maternal and fetal tissues, bones, and fluids
• Transvaginal or Abdominal
• First trimester use: pelvic anatomy, assess developing embryo/fetus for number and size, locate placenta, diagnose intrauterine pregnancy, screen for fetal and placental anomalies, and establish gestational age
• Later in pregnancy: fetal viablity, number, position, gestational age, growth pattern and anomlies, amniotic fluid voume, placental location and maturity and assessment of fetal well-being

Question 3

Purpose and nursing responsibilites of Biophysical Profile

Answer 3

• Assesses fetal well-being after at least 23-24 weeks gestation by determining scores on five criteria:
  
  1. Fetal breathing movements
  2. Body movements
  3. Muscle tone
  4. Heart rate activity
  5. Amniotic fluid volume
• 0-10 Scoring
  
  • 2 os govem of findings for a criterion are normal
  • 0 is given if findings for a criterion are abnormal
  • Total score of 8 to 10 is considered normal
  • 4-6 is possibly abnormal
  • Less than 4 may indicate a need for delivery

Question 4

Purpose and nursing responsbilities of Non-stress Test

Answer 4

• Assessment of fetal well-being that analyzes the response of the fetal heart to fetal movement
• Performed after at least 23-24 weeks gestation
• Client placed in semi-fowler’s position and an ultrasound transducer and tocodynamometer are used to record contractions and fetal heart rate
• Reactive or nonreactive

Question 5

Purpose and nursing responsibilites associated with Amniocentesis

Answer 5

1. Assess fetal well-being and maturity
2. Assists in prenatal diagnosis of genetic disorders or congenital anomalies, assessment of pulmonary maturity and diagnosis of fetal hemolytic disease
3. Needle is inserted through maternal abdominal wall to collect a sampe of amniotic fluid which contains fetal cells
4. Test can be done after 14-16 weeks gestation
5. Instruct client to contact health care provider if she experiences fluid loss, bleeding, fever, abdominal pain or increased or decreased fetal activity, inform that test results will be available in 2 weeks

Question 6

Purpose and nursing responsibilites associated with kick counts

Answer 6

1. Woman lies on her side, places her hands on the largest part of her abdomen and concentrates on fetal movements
2. Count fetal movements for 30 minutes 3X/day, daily for 1 hour, 30 minutes in the evening/30 minutes in morning, or count the first 10 movements and note the starting time and time of day when the tenth movement is felt
3. Notify if:
   
   1. Fewer than 3 movements in 1 hour
   2. No movement in 12 hours
   3. Fewer than 10 movements in a 2 hours period
   4. Fewer than 10 movements in 12 hours
   5. Decrease from baseline amount