The nurse is caring for a pregnant client with a decreased alpha-fetoprotein level. The nurse plans to
The nurse is caring for a pregnant client with a decreased alpha-fetoprotein level. The nurse plans to
A. notify the primary healthcare provider (PHCP) of the results.
[56%]
B. instruct the client to increase their intake of folic acid.
[29%]
C. document the result as normal.
[10%]
D. obtain a urine specimen.
[5%]
Statistics
Subject/Lesson
Subject
Maternal & Newborn Health
Lesson
Antepartum
Client Need
Test Plan
Health Promotion and Maintenance
Related Topic
Ante/Intra/Postpartum and Newborn Care
Item Type
Item Type
Application
Explanation
Choice A is correct. Alpha-fetoprotein (AFP) is a substance produced by the developing baby, which can enter both the amniotic fluid and the mother's bloodstream. Normally, a small amount of AFP is present in both the amniotic fluid and the maternal blood. However, in cases where a woman is carrying a baby with Down syndrome, AFP blood levels may be lower. Conversely, if AFP levels are elevated, it serves as a signal for the physician to conduct further investigations, as it may indicate the possibility of a neural tube defect or be related to a multifetal pregnancy. Regardless of the underlying cause of these variations in AFP levels, it is essential for the nurse to promptly inform the primary healthcare provider (PHCP) of the test results.
Choice B is incorrect. A neural tube defect can be detected with MSAFP, but an increase in folic acid will not change once the error has occurred. Taking folic acid before becoming pregnant and continuing through the pregnancy can be beneficial to prevent neural tube defects.
Choice C is incorrect. Documenting the result as normal would be inappropriate if the AFP level is actually decreased, as it may have clinical significance and require further evaluation.
Choice D is incorrect. Obtaining a urine specimen is not the primary action to take when dealing with a decreased AFP level in a pregnant client. The focus should be on communicating the abnormal result to the PHCP and determining the appropriate next steps in the client's care.
Additional Info
✓ Folic acid supplementation prevents neural tube defects (spina bifida, meningocele, myelomeningocele).
✓ Foods rich in folic acid include dark green leafy vegetables, whole grains, and grapefruit.
✓ AFP testing is typically performed between the 15th and 20th week of pregnancy. Nurses should coordinate with the healthcare team to schedule the test at an appropriate time, ensuring that the results can be acted upon if necessary.
✓ Be aware of cultural and religious beliefs that may influence a client's decision-making regarding prenatal screening and potential interventions. Respect for diversity and individual choices is crucial.
