A nurse is caring for a client at 29 weeks gestation that arrived to OB triage with complaints of uterine contractions every 45 minutes.
After the initial assessment, an order for Nifedipine was received.
The nurse is now evaluating the effects of the medication.
Which of the following assessments indicates the medication was effective?

Choice A rationale

Preeclampsia is concerning but the blood pressure of 138/82 mm Hg is not critically high at this moment. Preeclampsia is diagnosed by new-onset hypertension and proteinuria or significant end-organ dysfunction in the latter half of pregnancy. Immediate intervention isn't necessary unless symptoms worsen.

Choice B rationale

PPROM (Preterm Premature Rupture of Membranes) at 29 weeks gestation with a temperature of 39.1°C (102.3°F) suggests a possible infection which can be life-threatening for both the mother and the fetus. Prompt medical attention is critical to manage the infection and prevent sepsis.

Choice C rationale

Hyperemesis gravidarum, while uncomfortable and requiring intervention, is less immediately threatening compared to a severe infection. It involves excessive vomiting leading to dehydration and weight loss but doesn't pose an acute threat as severe infection does.

Choice D rationale

Placenta previa with no vaginal bleeding for the last 12 hours indicates stability. However, any bleeding during pregnancy can be concerning and needs careful monitoring, but immediate intervention is not as crucial as for an infection.

Choice A rationale

Performing another vaginal exam does not directly influence labor progress. Labor can progress naturally without repeated exams, which can introduce unnecessary risk.

Choice B rationale

While vaginal exams can be uncomfortable, pain is not the primary reason to avoid multiple exams, especially when managing potential complications.

Choice C rationale

Vaginal exams might lead to minor bleeding due to irritation, but the risk of bleeding is not a primary concern in this context.

Choice D rationale

The most significant reason to avoid frequent vaginal exams after PPROM is the increased risk of infection. Each exam provides a potential pathway for bacteria to ascend, leading to complications like chorioamnionitis.