A nurse in a gynecology office is caring for a client.
The physical examination reveals inflamed labia majora and minora and a large amount of frothy, yellow-green, malodorous discharge.
Based on the client’s medical record, which of the following prescriptions should the nurse anticipate receiving from the provider?

Choice A rationale

The maternal serum alpha-fetoprotein test is a part of what’s often called the “triple screen” that can assess whether a pregnant woman may be at increased risk of carrying a baby with certain disorders, such as neural tube defects (spinal defects) or Down syndrome.

Choice B rationale

While the test can provide information about the risk of certain birth defects, it does not assess various markers of fetal well-being.

Choice C rationale

The test does not identify an Rh incompatibility between the mother and fetus. That would be determined through separate blood tests.

Choice D rationale

The test does not assess fetal lung maturity. Other tests, such as amniocentesis, can provide this information.

Choice A rationale

While bile does play a role in digestion, it is not retained in the liver. Instead, it is produced by the liver and stored in the gallbladder. When food enters the small intestine, the gallbladder releases bile to aid in the digestion of fats. However, this process is not directly related to heartburn during pregnancy.

Choice B rationale

During pregnancy, the body produces large amounts of the hormones progesterone and relaxin. These hormones tend to relax smooth muscle tissues throughout the body, including those in the gastrointestinal (GI) tract. As a result, food sometimes moves more slowly through the system, resulting in indigestion issues of all kinds, from that bloated, gassy feeling to heartburn. This is the correct answer because increased progesterone production does indeed cause decreased motility of smooth muscle, which can lead to heartburn.

Choice C rationale

While estrogen levels do increase during pregnancy, they do not directly cause an increase in the secretion of hydrochloric acid. Instead, the relaxation of the lower esophageal sphincter due to pregnancy hormones can allow stomach acid to flow back up into the esophagus, causing heartburn.

Choice D rationale

While it is true that the growing uterus can displace the stomach, especially in later stages of pregnancy, this is not the primary cause of heartburn. Heartburn is primarily caused by the relaxation of the lower esophageal sphincter, allowing stomach acid to flow back up into the esophagus.