A nurse is caring for a 28-year-old female client in the emergency department. The client is experiencing symptoms suggesting the risk of preterm birth.
Complete the following sentence by using the lists of options.
The nurse should identify that the client is at the greatest risk for preterm birth due to fetal fibronectin:
The Correct Answer is {"dropdown-group-1":"B","dropdown-group-2":"B"}
The nurse should identify that the client is at the greatest risk for preterm birth due to:
Response 1: B) being higher than normal (fetal fibronectin: 0.09 mcg/mL is higher than the normal level of ≤ 0.05 mcg/mL).
Response 2: B) Nitrazine and ferning tests negative
Here's the
- Fetal Fibronectin: Fetal fibronectin is a protein found between the amniotic sac and the uterine lining. Levels greater than 0.05 mcg/mL (like 0.09 mcg/mL) indicate an increased risk of preterm labor.
- Nitrazine and Ferning Tests: Both tests being negative indicates that there is no rupture of membranes. Even though these tests are negative, the elevated fetal fibronectin level still indicates a risk for preterm birth.
So the completed sentence would be: The nurse should identify that the client is at the greatest risk for preterm birth due to fetal fibronectin being higher than normal and Nitrazine and ferning tests negative.
This combination of findings suggests that preterm labor may be imminent despite the lack of membrane rupture. The elevated fetal fibronectin is a strong indicator of risk.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Terbutaline can cause tachycardia. A heart rate of 132/min is significantly higher than normal and could indicate severe cardiovascular effects.
Choice B rationale
While headaches can occur with terbutaline, they are generally not life-threatening and don't require immediate intervention compared to tachycardia.
Choice C rationale
Nasal congestion is a minor side effect and not a priority compared to a significantly elevated heart rate.
Choice D rationale
Tremors are common with terbutaline use, but they are usually not as concerning as a significantly elevated heart rate.
Correct Answer is ["B","C","D","E","F"]
Explanation
B. "You may experience a headache after receiving this medication."
- Some tocolytic medications can cause headaches as a side effect.
C. "It is common for this medication to make you feel jittery."
- Tocolytic medications, such as terbutaline, can cause nervousness or jitteriness.
D. "This medication should decrease your contractions."
- The primary purpose of tocolytic medication is to decrease uterine contractions and delay preterm labor.
E. "I'll check your reflexes frequently while you are receiving this medication."
- Some tocolytic medications, like magnesium sulfate, require monitoring of deep tendon reflexes to assess for potential toxicity.
F. "This medication can make your heart beat faster."
- Tocolytic medications, such as terbutaline, can increase heart rate.
These statements provide the client with a comprehensive understanding of the purpose of the medication and its potential side effects.
The incorrect statements are:
- A. "I will inject this medication under your skin.": Tocolytic medications are typically administered orally, intravenously, or intramuscularly, not subcutaneously.
- G. "This medication can increase your blood pressure.": Some tocolytic medications, like magnesium sulfate, can actually lower blood pressure rather than increase it.
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