The nurse is teaching a client about chorionic villus sampling prior to the procedure. Which client statement(s) indicates that the teaching was effective? (Select all that apply).

Choice A rationale Ultrasound is a vital component of chorionic villus sampling (CVS) to provide real-time visualization of the placenta and the needle or catheter placement. This ensures that the clinician can safely obtain a sample of the chorionic villi without injuring the fetus or the mother. The use of ultrasound reduces the risk of procedural complications such as hemorrhage or accidental pregnancy loss. Seeing the fetus during the procedure also allows for the assessment of fetal heart tones. Choice B rationale This statement is incorrect because chorionic villus sampling is typically performed between 10 and 13 weeks of gestation. Performing the procedure at 18 to 20 weeks would be inappropriate, as amniocentesis is the standard diagnostic tool used during the second trimester. CVS is specifically designed for early first-trimester genetic screening. Performing CVS too early (before 10 weeks) is associated with limb reduction defects, while performing it too late loses the benefit of early diagnosis and decision-making for the parents. Choice C rationale This statement is incorrect because CVS involves the removal of a small piece of placental tissue (chorionic villi) rather than amniotic fluid. Amniotic fluid is obtained during an amniocentesis. While both tests provide genetic information, CVS does not evaluate for neural tube defects because it does not measure alpha-fetoprotein levels found in the amniotic fluid. The client must understand that the tissue sample is what will be analyzed for chromosomal abnormalities like Down syndrome or other genetic conditions. Choice D rationale Rho(D) immune globulin (RhoGAM) is required for Rh-negative clients undergoing CVS because the procedure carries a risk of fetomaternal hemorrhage. If fetal blood cells enter the maternal circulation, the mother could develop antibodies against the Rh factor, leading to hemolytic disease of the newborn in future pregnancies. Administering RhoGAM prevents this sensitization. This is a standard prophylactic measure for any invasive prenatal procedure where blood mixing might occur, regardless of whether the procedure is performed transabdominally or transcervically. Choice E rationale For a transabdominal CVS procedure, a full bladder is often required to help displace the uterus upward and provide a better acoustic window for the ultrasound. This improves the visualization of the placental site and allows for safer needle insertion. If the procedure is performed transcervically, the bladder requirements may vary, but a full bladder is a common preparatory step in early pregnancy imaging and procedures to optimize the view of pelvic structures and the developing gestational sac.