The nurse is reviewing nursing documentation related to the care of a client who had an amniocentesis. Which nursing note reflects appropriate client care?
1. Prior to discharge, the client demonstrated vaginal spotting.
2. An Rh-positive client received RhoGAM after the amniocentesis.
3. The client was monitored for 30 minutes after completion of the test.
4. The client reported that she takes insulin before each meal and at bedtime.
3
Explanation:
1. Vaginal spotting after the amniocentesis is not an expected finding. A client experiencing vaginal bleeding of any amount after amniocentesis requires additional assessment and should not be sent home.
2. Only Rh-negative clients receive RhoGAM after amniocentesis. The Rh-positive client should not ever receive RhoGAM.
3. Twenty to 30 minutes of fetal monitoring is performed to assess for fetal well-being and to rule out injury of the fetus or placenta during the examination.
4. Whether or not a client takes insulin has nothing to do with amniocentesis. This answer does not relate to the question asked.
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