A G1P1 patient at 37 weeks' gestation is scheduled for a nonstress test (NST). The nurse's greatest concern is the client's risk of developing related to

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Choice A rationale

Betamethasone does not directly increase the fetal heart rate. Factors influencing fetal heart rate include fetal oxygenation, maternal hydration, and medications affecting the maternal or fetal autonomic nervous system. Normal fetal heart rate ranges from 110 to 160 beats per minute.

Choice B rationale

Betamethasone is a corticosteroid administered to pregnant women at risk of preterm delivery to accelerate fetal lung maturity. It stimulates the production of surfactant, a lipoprotein that reduces surface tension in the alveoli, preventing collapse upon expiration and improving the neonate's ability to breathe independently.

Choice C rationale

Betamethasone does not halt cervical dilation. Cervical dilation is primarily influenced by uterine contractions and the presenting fetal part. Medications like tocolytics, such as terbutaline or magnesium sulfate, are used to inhibit uterine contractions in preterm labor.

Choice D rationale

Betamethasone is not used to stop preterm labor contractions. Its primary purpose is to enhance fetal lung maturation. Tocolytic medications are the class of drugs used to attempt to delay or stop preterm labor contractions, allowing time for corticosteroids to be administered.

Choice A rationale

Thrombophlebitis, while a postpartum risk, is more commonly associated with factors like immobility, hypercoagulability of pregnancy, and cesarean birth. The immediate postpartum period after a vaginal birth is a lower risk time compared to later in the puerperium.

Choice B rationale

Puerperal infection typically manifests 24 hours or more postpartum, with signs like fever, uterine tenderness, and foul-smelling lochia. While the client is at risk in the coming days, it is not the immediate primary concern at 5 hours postpartum.

Choice C rationale

Retained placental fragments can lead to postpartum hemorrhage and infection, but the immediate risk after a vaginal birth of a large baby is more related to the uterus's ability to contract effectively. Signs would typically include persistent heavy bleeding.

Choice D rationale

Uterine atony, a failure of the uterus to contract adequately after birth, is a significant risk in the immediate postpartum period, especially following the delivery of a large infant (macrosomia). The overdistension of the uterus during pregnancy with a large fetus can impair its ability to contract firmly, leading to postpartum hemorrhage.