A nurse is caring for a client who is at 33 weeks of gestation and has pre-term labor.

The client reports a sudden gush of fluid from her vagina.

Which of the following actions should the nurse take first?

“This medication can cause premature closure of your baby’s ductus arteriosus.”

Indomethacin is a NSAID that can prevent the synthesis of prostaglandins, which are involved in preterm contractions.However, it can also cause constrictive effects on the fetal ductus arteriosus, which can lead to cardiac complications and oligohydramnios.The dosage and duration of indomethacin treatment should be carefully monitored.

Choice B is wrong because indomethacin does not increase the risk of postpartum hemorrhage.In fact, it may reduce the risk of bleeding by inhibiting platelet aggregation.

Choice C is wrong because indomethacin does not cause jaundice in the baby.

Jaundice is caused by high levels of bilirubin in the blood, which can be due to various factors such as blood group incompatibility, infection, or liver problems.

Choice D is wrong because indomethacin does not increase blood pressure during labor.It may actually lower blood pressure by dilating blood vessels.

Normal ranges for indomethacin dosage are 25 to 50 mg orally every 6 hours or 100 mg rectally every 12 hours for up to 48 hours.

Normal ranges for fetal ductus arteriosus diameter are 1.5 to 4 mm before 28 weeks of gestation and 1 to 3 mm after 28 weeks of gestation.

Tachycardia.

Terbutaline is a medication that can be used to stop or delay preterm labor by relaxing the uterine muscles.However, it can also cause serious side effects for both the mother and the baby.One of the most common side effects of terbutaline is tachycardia, which means a fast or irregular heartbeat.This can lead to chest pain, palpitations, shortness of breath, and even cardiac arrhythmias or ischemia.

Therefore, the nurse should monitor the mother’s heart rate and rhythm closely when administering terbutaline.

Choice A is wrong because terbutaline does not cause hypotension, which means low blood pressure.In fact, terbutaline can increase blood pressure by constricting blood vessels.

Choice C is wrong because terbutaline does not cause hyperglycemia, which means high blood sugar.However, terbutaline can interfere with insulin secretion and glucose metabolism in some cases, especially in diabetic mothers.

Therefore, the nurse should monitor the mother’s blood sugar levels when administering terbutaline.

Choice D is wrong because terbutaline does not cause hypokalemia, which means low potassium levels in the blood.However, terbutaline can cause a temporary increase in potassium levels in the baby, which can affect the baby’s heart function.

Therefore, the nurse should monitor the baby’s heart rate and rhythm when administering terbutaline.

Normal ranges for heart rate are 60 to 100 beats per minute for adults and 120 to 160 beats per minute for fetuses.

Normal ranges for blood pressure aretypically between 90/60 mmHg and 120/80 mmHg.