Question

Case Study: Jan (4-2-1-0-2), age 42 is 18 weeks pregnant. Her primary health care provider has suggested an amniocentesis because of her age and a family history of a genetic disorder, both of which place Jan’s fetus at risk for genetic anomalies. Jan’s blood type is A negative and her partner’s, the father of her baby, is B positive. Describe the nurse’s role in terms of each of the following.

1. How will you prepare Jan for the amniocentesis?

2. What measures will you implement to support Jan during the procedure?

3. List the important post procedure care and instructions.

4. What are the indicators for the use of amniocentesis during pregnancy?

Answer 1

1. How will you prepare Jan for the amniocentesis?

Patients should know about the portrayal of the strategy and the dangers, including yet not constrained to fetal as well as maternal disease, fetal harm, preterm work, cut of maternal organs, detachment of the placenta, and conceivable unnatural birth cycle, which happens between 1 case in 200 and 1 case in 1000 for hereditary amniocentesis.

Furthermore, hereditary amniocentesis can identify every chromosomal inconsistency and a few yet not every single hereditary infection. Hence, the patient needs to comprehend the confinements of this technique and testing.

The patient does not should be in a fasting state, in spite of the fact that it might be prescribed if the amniocentesis is performed at a gestational age when the baby is suitable, if a quick mediation, for example, a cesarean should be performed.

Amniocentesis is normally performed at the doctor's office ultrasound room or in the work and conveyance unit of a healing center prepared to oversee inconveniences. The mother's blood classification and gathering, number of babies, and a gross assessment for anatomical oddities ought to be performed in advance. Fetal heart tones, placental position, and circulation of the amniotic liquid ought to be assessed just before the methodology.

Quiet Preparation

Anesthesia

Anesthesia is generally not really amid amniocentesis in light of the fact that the needle utilized has a little breadth; in spite of the fact that, in a few circumstances, a patient may profit by the utilization of anesthesia or anxiolytics. Some inconvenience might be experienced by the patient with the underlying addition of the needle into the skin.

Situating

The patient as a rule lies in a dorsal lithotomy position to uncover the skin of the stomach area to the administrator. Once in a while the patient is requested to turn her body to one side or right side, contingent upon the position of the placenta, embryo, and the appropriation of amniotic liquid in the uterine cavity.

2. What measures will you implement to support Jan during the procedure?

In the event that she is having amniocentesis done before week 20 of pregnancy, it may be useful to have your bladder full amid the strategy to help the uterus. Drink a lot of liquids before her arrangement.

Human services supplier will clarify the methodology and request that her sign an assent frame before the technique starts. Think about requesting that somebody go with her to the arrangement for enthusiastic help or to drive her home a short time later.

What she can anticipate

Amniocentesis is typically done in an outpatient office or the social insurance supplier's office.

Amid the strategy

To begin with, social insurance supplier will utilize ultrasound to decide the infant's correct area in her uterus. She will lie on her back on an exam table and uncover her stomach area. Her human services supplier will apply an uncommon gel to her mid-region and afterward utilize a little gadget known as a ultrasound transducer to demonstrate child's position on a screen.

Next, human services supplier will clean stomach area with a germicide. By and large, sedative isn't utilized. Most ladies report just gentle uneasiness amid the methodology.

Guided by ultrasound, medicinal services supplier will embed a thin, empty needle through stomach divider and into the uterus. A little measure of amniotic liquid will be pulled back into a syringe, and the needle will be expelled. The particular measure of amniotic liquid pulled back relies upon the quantity of weeks the pregnancy has advanced.

She should lie still while the needle is embedded and the amniotic liquid is pulled back. She may see a stinging sensation when the needle enters her skin, and she may feel cramping when the needle enters her uterus.

3. List the important post procedure care and instructions.

After the technique

After the technique is finished, the nearness of fetal heart tones by ultrasound ought to be acquired and archived; likewise record seeping through the needle addition site, stomach torment, or constrictions. On the off chance that the patient is Rh negative and nonsensitized, she will require 300 micrograms of Rhogam to keep the age of against D antibodies.

The most widely recognized entanglement after an amniocentesis is cramping; it as a rule goes on for under 2 hours. Chorioamnionitis is uncommon yet may have a deadly fetal result. Vaginal draining or spillage of liquid happens in around 2% of cases, and more often than not this is self-constrained.

Unsuccessful labor after amniocentesis has been customarily announced as 1 out of 200, however latest investigations report the hazard to be 1 of every 1,000. Amniocentesis before 15 weeks incubation, utilization of expansive needles, numerous endeavors, and unrecognized chorioamnionitis postprocedure are chance variables for unnatural birth cycle. The danger of talipes equinovarus is hoisted if the amniocentesis is performed preceding 15 weeks incubation.

After the amniocentesis, her human services supplier will keep utilizing the ultrasound to screen her child's heart rate. She may encounter cramping or mellow pelvic inconvenience after an amniocentesis.

She can continue her typical action level after the methodology. In any case, she should seriously mull over maintaining a strategic distance from strenuous exercise and sexual movement for a day or two.

Then, the example of amniotic liquid will be broke down in a lab. A few outcomes may be accessible inside a couple of days. Different outcomes may take up to a month.

Contact human services supplier on the off chance that she have:

• Loss of vaginal liquid or vaginal dying
• Severe uterine cramping that keeps going more than a couple of hours
• Fever
• Redness and aggravation where the needle was embedded Unusual fetal action or an absence of fetal development

4. What are the indicators for the use of amniocentesis during pregnancy?

Amniocentesis should be possible for different reasons:

• Genetic testing. Hereditary amniocentesis includes taking an example of amniotic liquid and testing it for specific conditions, for example, Down disorder.
• Fetal lung testing. Fetal lung development testing includes taking an example of amniotic liquid and testing it to decide if the infant's lungs are develop enough for birth.
• Diagnosis of fetal disease. Every so often, amniocentesis is utilized to assess a child for contamination or different sickness. The technique likewise should be possible to assess the seriousness of sickliness in babies who have Rh sharpening — an unprecedented condition in which a mother's resistant framework produces antibodies against a particular protein on the surface of the child's platelets.
• Treatment. On the off chance that you gather excessively amniotic liquid amid pregnancy (polyhydramnios), amniocentesis may be done to empty overabundance amniotic liquid out of your uterus.