A client's amniocentesis results indicate that the fetus is at ...

[big1devin]

A client's amniocentesis results indicate that the fetus is at risk for respiratory distress. What testing values support this clinical decision? Select all that apply.
 
  1. Amniotic glucose level 50 mg/dL
  2. Phosphatidylglycero l (PG) negative
  3. Lecithin/sphingomyelin (L/S) ratio 1:6
  4. Amniotic fluid red blood cell count 5 mg/dL
  5. Lamellar body counts (LBCs) 5000/counts/mcL

Question 2

The nurse is reviewing amniocentesis with a pregnant client. In which order should the nurse explain the steps that will occur during this procedure?
 
  1. Conduct an ultrasound
  2. Fetal heart rate assessed
  3. Local anesthetic provided
  4. Skin cleansed with antiseptic solution
  5. Insertion site observed for fluid streaming
  6. 22-gauge needle inserted to withdraw amniotic fluid

[Swizqar]

Answer to Question 1

2, 3, 5
Explanation:
1. There is no information to support the use of amniotic fluid glucose level to predict respiratory functioning.
2. The absence of phosphatidylglycero l (PG) indicates the fetal lungs are not mature.
3. Lecithin and sphingomyelin are two components of surfactant. Early in pregnancy, the sphingomyelin concentration in amniotic fluid is greater than the concentration of lecithin, and so the L/S ratio is low (lecithin levels are low and sphingomyelin levels are high). This can result in the development of respiratory distress syndrome (RDS).
4. There is no information to support the use of amniotic fluid red blood cell counts to predict respiratory functioning.
5. When the LBC is 30,000 to 40,000 counts/mcL, probable lung maturity is assumed.

Answer to Question 2

1, 4, 3, 6, 5, 2
Explanation:
1. An ultrasound is performed first to identify amniotic fluid pockets.
2. Fetal heart rate is assessed last.
3. A local anesthetic is provided after the skin is cleansed.
4. Skin is cleansed after the ultrasound.
5. Fluid streaming occurs after the 22-gauge needle is removed.
6. A 22-gauge needle is inserted after the local anesthetic.