A nurse is reinforcing teaching with a client who is 15 weeks pregnant about to undergo amniocentesis. This test can identify which traits or problems? Select all that apply.

Choice A:
Rh incompatibility is not directly identified through amniocentesis. Instead, it's typically assessed through blood tests that determine a woman's Rh factor and screen for Rh antibodies.
However, amniocentesis can provide information that might be relevant to Rh incompatibility, such as the fetal Rh type. If the mother is Rh-negative and the fetus is Rh-positive, there's a risk of Rh incompatibility.

Choice B:
Amniocentesis can detect neural tube defects (NTDs) like spina bifida and anencephaly.
It does this by measuring the levels of alpha-fetoprotein (AFP) in the amniotic fluid. AFP is a protein produced by the fetal liver, and elevated levels in the amniotic fluid can indicate an NTD.

Choice C:
Amniocentesis can accurately determine the fetal gender by examining the sex chromosomes present in the cells of the amniotic fluid.

Choice D:
Cephalopelvic disproportion (CPD) is a condition where the baby's head is too large to fit through the mother's pelvis. It's not diagnosed through amniocentesis.
CPD is usually suspected based on clinical findings like a slow progression of labor or a high fetal station, and it might be confirmed with imaging techniques like X-ray or ultrasound.

Choice E:
Amniocentesis is a valuable tool for diagnosing chromosomal defects, such as Down syndrome, Trisomy 18, and Trisomy 13. It does this by analyzing the chromosomes of the fetal cells present in the amniotic fluid.

Rationale for Choice A:
Judgmental and shaming: The statement "You are so young. Are you sure you are ready for the responsibilities of a sexual relationship?" conveys judgment and may make the adolescent feel ashamed or embarrassed. This can create a barrier to open communication and discourage the teen from seeking further guidance.
Dismisses the teen's concerns: It does not directly address the teen's question about contraception, suggesting that her concerns are not valid or important.
Does not provide helpful information: It does not offer any guidance or education about contraception, leaving the teen without the information she needs to make informed decisions about her sexual health.

Rationale for Choice B:
Erects barriers to access: Requiring parental consent for an examination can delay or prevent the teen from obtaining contraception, even if she is legally allowed to do so without parental consent.
Discourages open communication: It may make the teen feel like she cannot trust the nurse or that her privacy will not be respected, leading her to withhold information or avoid seeking further help.

Rationale for Choice C:
Defers responsibility: It shifts the responsibility for providing contraception counseling to the doctor, potentially delaying the teen's access to information and services.
May not be necessary: A physical examination is not always required before prescribing contraception, and in some cases, a nurse practitioner or other qualified health professional can provide this service.

Rationale for Choice D:
Open and non-judgmental: It invites the teen to share information about her sexual activity without judgment or pressure. Gathers essential information: It allows the nurse to assess the teen's individual needs and preferences, which is crucial for recommending the most appropriate contraceptive method.
Promotes informed decision-making: It empowers the teen to make informed choices about her sexual health by providing her with accurate and comprehensive information about contraception.