A nurse is caring for a client who is at 32 weeks of gestation and reports lower abdominal cramping.

Which of the following actions should the nurse take first?

Assess the client’s vital signs

Perform a sterile vaginal exam

Administer tocolytic medication

Monitor the fetal heart rate

Answer and Explanation

The Correct Answer is A

Assess the client’s vital signs.

The nurse should first assess the client’s vital signs to determine the severity of the situation and identify any signs of infection, bleeding, or shock.

The nurse should also monitor the fetal heart rate to assess fetal well-being.

Choice B is wrong because a sterile vaginal exam is not indicated for a client who reports lower abdominal cramping and may increase the risk of infection or rupture of membranes.

Choice C is wrong because administering tocolytic medication is not the first action the nurse should take.

Tocolytic medication may be used to inhibit uterine contractions and prolong pregnancy, but only after assessing the client’s and fetus’s condition and obtaining a prescription from the provider.

Choice D is wrong because monitoring the fetal heart rate is not the first action the nurse should take.

Monitoring the fetal heart rate is important to assess fetal well-being, but it does not take priority over assessing the client’s vital signs.

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Correct Answer is B

Explanation

A cervical cerclage is a procedure that involves placing stitches around the cervix to prevent it from opening prematurely.This procedure is usually done for women who have a history of cervical insufficiency or a short cervix, which are risk factors for preterm labor.

Choice A is wrong because history of gestational diabetes is not a risk factor for preterm labor.

Gestational diabetes is a condition that causes high blood sugar during pregnancy and can affect the health of the mother and the baby, but it does not increase the risk of preterm labor.

Choice C is wrong because history of recurrent urinary tract infections (UTIs) is a risk factor for preterm labor.

UTIs are infections that affect the urinary system and can cause symptoms such as pain, burning, or frequent urination.

UTIs can also spread to the kidneys or the uterus and cause inflammation or infection that can trigger preterm labor.

Choice D is wrong because history of assisted reproductive technology (ART) is a risk factor for preterm labor.

ART refers to any medical procedure that helps with conception, such as in vitro fertilization (IVF).

ART can increase the risk of preterm labor because it can result in multiple gestations (twins, triplets, or more), which put more strain on the uterus and can cause it to contract prematurely.ART can also cause complications such as placenta previa or rupture of the uterus, which can lead to preterm labor.

A. Encourage the parents to touch and talk to the infant through the incubator ports B. Limit the parents’ visitation time to prevent overstimulation of the infant C. Advise the parents to avoid eye contact with the infant until he is stable D. Restrict the parents from holding or feeding the infant until he is discharged.

Correct Answer is A

Explanation

Encouraging the parents to touch and talk to the infant through the incubator ports can promote bonding between the infant and the parents.Bonding is the intense attachment that develops between parents and their baby, and it is essential for the baby’s social and cognitive development.Touch and communication are some of the ways that babies bond with their parents.

Choice B is wrong because limiting the parents’ visitation time can disrupt the bonding process and make the parents feel less involved in their baby’s care.

Choice C is wrong because eye contact is another way of bonding with babies, and it can help them feel secure and loved.

Choice D is wrong because holding and feeding the infant are also important ways of bonding, and they should not be restricted unless medically necessary.

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A nurse is caring for a client who is at 32 weeks of gestation and reports lower abdominal cramping. Which of the following actions should the nurse take first?

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A nurse is caring for a client who is at 32 weeks of gestation and reports lower abdominal cramping.

Which of the following actions should the nurse take first?