Health Promotion and Maintenance
51. A client at 12 weeks' gestation is at her first prenatal visit. The client is given instructions to get prenatal labs and a multiple marker screen drawn at the laboratory. She asks a nurse about the purpose of the multiple marker screen. The nurse should inform the client that the conditions that may be detected with this test are: Select all that apply.
. Gestational diabetes.
. Edwards' syndrome.
. Pregnancy-induced hypertension.
. Trisomy 21.
. Neural tube defects.
Test-Taking Tip
Select the three options that are congenital (Answers 2, 4, and 5). Multiple marker screen is usually performed about 16 weeks' gestation; gestational diabetes and pregnancy-induced hypertension are conditions that are usually found during the third trimester of pregnancy.
Content Area: Maternity, Antepartum; Integrated Process: Nursing Process, Analysis; Cognitive Level: Application; Client Need/Subneed: Health Promotion and Maintenance/Ante/Intra/Postpartum and Newborn Care
Health Promotion and Maintenance
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Answer 1 is incorrect because gestational diabetes cannot be detected in the multiple marker screen; the correct screening test is a 1-hourglucose tolerance test. Answer 2 is correct because Edwards' syndrome (trisomy 18) is one of the conditions that may be detected by the multiple marker screen. It is a severe, usually lethal developmental disorder. It is characterized by cranial, neurological, facial, cardiac, and GI malformations. Answer 3 is incorrect because pregnancy-induced hypertension cannot be detected in the multiple marker screen. Serial blood pressure readings, urine protein, and liver and renal function tests are the screening tests for pregnancy-induced hypertension. Answer 4 is correct because Down syndrome (trisomy 21) is one of the conditions that may be detected by the multiple marker screen. Answer 5 is correct because neural tube defects are conditions that may be detected by the multiple marker screen.