To help pregnant clients manage discomfort and pain during labor, what is a nurse aware of?

Choice A rationale:

Incorrect. The quad screen test does not examine fetal DNA to determine gender. That is the role of other tests, such as amniocentesis or chorionic villus sampling (CVS).

Gender determination is not a primary objective of the quad screen test.

Focusing on gender unnecessarily narrows the scope of the test's potential findings.

Choice B rationale:

Incorrect. The quad screen test does not use fetal tissue. It is a non-invasive blood test that measures levels of four substances in the mother's blood: alpha-fetoprotein (AFP), human chorionic gonadotropin (hCG), unconjugated estriol (uE3), and inhibin A.

Fetal tissue sampling is more invasive and carries risks, while the quad screen is a safer alternative.

Clarifying the non-invasive nature of the test is crucial for informed consent and patient understanding.

Choice C rationale:

Incorrect. While AFP levels can be affected by maternal liver function, that is not the primary focus of the quad screen test.

Liver function tests are specifically designed to assess liver health, and they are not part of the quad screen panel.

Distinguishing between liver function assessment and AFP's role in screening for fetal anomalies is essential for accurate interpretation.

Choice D rationale:

Correct. The quad screen test measures levels of AFP, hCG, uE3, and inhibin A in the mother's blood. These substances can provide information about the risk of certain fetal chromosomal abnormalities and neural tube defects.

Elevated AFP levels can indicate an increased risk for neural tube defects such as spina bifida or anencephaly.

Low AFP levels can be associated with Down syndrome or other chromosomal abnormalities.

Understanding the specific disorders that can be indicated by AFP levels is crucial for patient counseling and further testing decisions.

Choice A rationale:

Visceral pain arises from the internal organs and is often described as dull, aching, cramping, or squeezing. During the first stage of labor, the uterus contracts forcefully to dilate the cervix and move the baby down the birth canal. This stretching and pressure on the uterus, cervix, and other pelvic organs stimulate pain receptors, resulting in visceral pain. This pain is typically located in the lower abdomen, back, and groin.

Key points about visceral pain in the first stage of labor:

It's often described as dull, aching, cramping, or squeezing.

It's caused by the stretching and pressure on the uterus, cervix, and other pelvic organs.

It's typically located in the lower abdomen, back, and groin.

It can be intermittent or continuous.

It can vary in intensity from mild to severe.

It's often accompanied by other symptoms such as nausea, vomiting, sweating, and anxiety.

Choice B rationale:

Referred pain is pain that is felt in a different location from the source of the pain. It's not typically associated with the first stage of labor.

Choice C rationale:

Somatic pain arises from the skin, muscles, bones, and joints. It's often described as sharp, stabbing, burning, or throbbing. The somatic pain of the second stage of labor is caused by the stretching and distension of the perineum and vagina as the baby descends. It's typically located in the lower back, buttocks, and thighs.

Choice D rationale:

Pain during the third stage of labor is typically mild compared to the first and second stages. It's caused by the contractions of the uterus as it expels the placenta. It's usually located in the lower abdomen and may be accompanied by a feeling of pressure or fullness.