A client's amniocentesis results indicate that the fetus is at risk for respiratory distress. What testing values support this clinical decision? Select all that apply
1. Amniotic glucose level 50 mg/dL
2. Phosphatidylglycerol (PG) negative
3. Lecithin/sphingomyelin (L/S) ratio 1:6
4. Amniotic fluid red blood cell count 5 mg/dL
5. Lamellar body counts (LBCs) 5000/counts/mcL
2, 3, 5
Explanation:
1. There is no information to support the use of amniotic fluid glucose level to predict respiratory functioning.
2. The absence of phosphatidylglycerol (PG) indicates the fetal lungs are not mature.
3. Lecithin and sphingomyelin are two components of surfactant. Early in pregnancy, the sphingomyelin concentration in amniotic fluid is greater than the concentration of lecithin, and so the L/S ratio is low (lecithin levels are low and sphingomyelin levels are high). This can result in the development of respiratory distress syndrome (RDS).
4. There is no information to support the use of amniotic fluid red blood cell counts to predict respiratory functioning.
5. When the LBC is 30,000 to 40,000 counts/mcL, probable lung maturity is assumed.
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