The primary reason for evaluating AFP levels in maternal serum is ...

[abern]

The primary reason for evaluating AFP levels in maternal serum is to determine whether the fetus has:
 
  a. Hemophilia.
  b. A neural tube defect.
  c. Sickle cell anemia.
  d. A normal lecithin-sphingomyelin ratio.

Question 2

A woman who had two previous cesarean births is in active labor, when she suddenly complains of pain between her scapulae. The nurse's priority action should be to:
 
  a. Reposition the woman with her hips slightly elevated.
  b. Observe for abnormally high uterine resting tone.
  c. Decrease the rate of nonadditive intravenous fluid.
  d. Notify the physician promptly.

[samiel-sayed]

Answer to Question 1

B
An open neural tube allows a high level of AFP to seep into the amniotic fluid and enter the maternal serum.
Hemophilia is a genetic defect and is best detected with chromosomal studies such as cho-rionic villus sampling or amniocentesis.
Sickle cell anemia is a genetic defect and is best detected with chromosomal studies such as chorionic villus sampling or amniocentesis.
L/S ratios are determined with an amniocentesis and is usually done in the third trimester.

Answer to Question 2

D
Pain between the scapulae may occur when the uterus ruptures because blood accumulates under the diaphragm. This is an emergency that requires medical intervention.
Repositioning the woman with her hips slightly elevated is the treatment for a prolapsed cord. That position in this scenario would cause respiratory difficulties.
Observing for high uterine resting tones should have been done before the sudden pain. High uterine resting tones put the woman at high risk for uterine rupture.
The woman is now at high risk for shock. Nonadditive intravenous fluids should be in-creased.

[abern]

Thanks for the timely response, appreciate it

[shewald78]

Great answer, keep it coming