A client at 28 weeks of gestation presents with bleeding from the vagina.

Which assessment finding should the nurse prioritize?

A. Referral to community services for support.

A client in preterm labor who is being discharged from the hospital needs to have a discharge plan that includes education, follow-up care, and support services.A referral to community services for support can help the client cope with the stress and anxiety of preterm labor, access resources such as home health care or social workers, and prevent complications or recurrence of preterm labor.

B. Encouragement to smoke in moderation is wrong because smoking is harmful for both the mother and the baby.

Smoking can increase the risk of preterm labor, low birth weight, placental abruption, and sudden infant death syndrome (SIDS).Smoking should be avoided completely during pregnancy and after delivery.

C. Instructions for heavy lifting and strenuous exercise is wrong because these activities can trigger uterine contractions and increase the risk of preterm labor.

A client in preterm labor should rest as much as possible and avoid physical exertion.The client should also avoid sexual intercourse, which can stimulate the cervix and cause bleeding or infection.

D. Recommendation to avoid kangaroo care is wrong because kangaroo care is a method of holding a newborn skin-to-skin with the mother or father.

Kangaroo care can have many benefits for preterm babies, such as improving temperature regulation, breathing, heart rate, feeding, bonding, and growth.Kangaroo care can also reduce stress and pain for both the baby and the parent.

Nitrazine paper test.

This test involves putting a drop of fluid obtained from the vagina onto paper strips containing nitrazine dye.

The strips change color depending on the pH of the fluid.The strips will turn blue if the pH is greater than 6.0, which indicates the presence of amniotic fluid.This test can help confirm rupture of membranes (ROM) in pregnancy, especially when preterm labor is suspected.

Choice B. Ferning test.This test involves examining a sample of vaginal fluid under a microscope and looking for a fern-like pattern that is formed by dried amniotic fluid crystals.This test can also help confirm ROM, but it is less reliable than the nitrazine test because other substances such as cervical mucus, semen, or blood can also cause ferning.

Choice C. Amniotic fluid index.This test involves measuring the amount of amniotic fluid in the uterus using ultrasound.This test can help assess the fetal well-being and detect conditions such as oligohydramnios (low amniotic fluid) or polyhydramnios (high amniotic fluid).This test cannot confirm ROM by itself, but it can be used in combination with other tests to evaluate the status of the pregnancy.

Choice D. Biophysical profile.This test involves using ultrasound and a fetal monitor to assess the fetal heart rate, breathing, movement, muscle tone, and amniotic fluid volume.