A client with pre-term labor is at 28 weeks of gestation.
Which intervention should the nurse prioritize to monitor fetal well-being?
Monitoring vital signs
Monitoring cervical changes
Monitoring fluid intake and output
Monitoring maternal preference
The Correct Answer is B
Monitoring cervical changes.
This is because cervical changes indicate the progress of labor and the risk of preterm delivery.
Preterm labor is defined as regular uterine contractions with cervical dilation and effacement before 37 weeks of gestation.
The nurse should assess the cervical length, dilation, effacement, and position frequently to determine the need for interventions to stop or delay labor.
Choice A is wrong because monitoring vital signs is not specific to fetal well-being.
Vital signs can reflect maternal health, infection, or complications, but they do not directly measure fetal status.
Choice C is wrong because monitoring fluid intake and output is not specific to fetal well-being.
Fluid balance can affect maternal hydration, electrolytes, and blood pressure, but it does not directly measure fetal status.
Choice D is wrong because monitoring maternal preference is not specific to fetal well-being.
Maternal preference can affect the comfort, satisfaction, and coping of the mother, but it does not directly measure fetal status.
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Correct Answer is C
Explanation
Administering corticosteroids.Corticosteroids are drugs that can speed up the development of the baby’s lungs and reduce the risk of respiratory distress syndrome and other complications of preterm birth.They are usually given to pregnant women who are at risk of preterm delivery between 24 0/7 weeks and 33 6/7 weeks of gestation.
Choice A is wrong because administering intravenous fluids does not enhance fetal lung maturity.
It may be used to treat dehydration or prevent hypotension, but it has no effect on the baby’s lungs.
Choice B is wrong because administering tocolytics does not enhance fetal lung maturity.
Tocolytics are drugs that can delay preterm labor for a short time, but they do not improve the baby’s lung function.
Choice D is wrong because providing emotional support does not enhance fetal lung maturity.
It may help the mother cope with stress and anxiety, but it does not affect the baby’s lungs.
Fetal lung maturity is the condition of the baby’s lungs being able to breathe normally after birth.It involves several developmental processes, such as the formation of alveoli, bronchi, and surfactant.
Fetal lungs are usually mature by 36 weeks of gestation, but some babies may need steroids to speed up lung development if they are at risk of preterm birth.
Correct Answer is A
Explanation
A decrease in fetal heart rate can indicate fetal distress due to infection, hypoxia, or cord compression.
Normal fetal heart rate is between 110 and 160 beats per minute.
Choice B. Increased uterine contractions is wrong because it is a normal sign of pre-term labor and does not necessarily indicate infection.
Choice C. Decreased fluid intake is wrong because it is not a specific sign of infection and can have other causes such as nausea, vomiting, or decreased thirst.
Choice D. Decreased cervical changes is wrong because it is also not a specific sign of infection and can indicate ineffective contractions or cervical incompetence.
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