A nurse is caring for a client who is in preterm labor at 32 weeks of gestation. The client asks the nurse. "Will my baby be okay?" Which of the following responses should the nurse offer?

"We have a neonatal unit here that's equipped to handle emergencies."

"Your pregnancy is advanced so your baby should be fine.

"You must be feeling scared and powerless.

"Everyone worries about her baby when she's in labor."

Answer and Explanation

The Correct Answer is D

Answer: C. "You must be feeling scared and powerless."

Rationale:

A) "We have a neonatal unit here that's equipped to handle emergencies.": While this statement provides some reassurance about the availability of care, it may come across as dismissive of the client's feelings. It does not directly address the emotional aspect of the client's concern, which is crucial during this stressful time.

B) "Your pregnancy is advanced so your baby should be fine.": This response may offer false reassurance. Although 32 weeks is relatively advanced in preterm terms, it does not guarantee that the baby will be fine, and the client's feelings and concerns are not acknowledged.

C) "You must be feeling scared and powerless.": This response is empathetic and validates the client's emotions. It opens up a dialogue for the client to express her feelings, allowing the nurse to provide emotional support and address her concerns more effectively.

D) "Everyone worries about her baby when she's in labor.": While this statement acknowledges that worry is common, it may downplay the client's specific fears. It does not provide the personalized support she needs or validate her unique situation.

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Correct Answer is C

Explanation

C) A client who has a diagnosis of preeclampsia reports epigastric pain and unresolved headache:
Epigastric pain and unresolved headache are signs of worsening preeclampsia, indicating possible impending eclampsia, a severe complication characterized by seizures. These symptoms suggest a significant deterioration in the client's condition and require immediate medical attention to prevent serious maternal and fetal complications.

A) A client who is at 28 weeks of gestation and receiving terbutaline reports fine tremors:
Fine tremors are a common side effect of terbutaline, which is often used to suppress preterm labor. While tremors can be uncomfortable for the client, they are not typically life-threatening and can often be managed without immediate medical intervention.

B) A client who has a diagnosis of preeclampsia has 2+ proteinuria and 2+ patellar reflexes:
While proteinuria and increased reflexes are indicative of preeclampsia, they are not immediate concerns unless other severe symptoms are present. However, the combination of epigastric pain and unresolved headache in a client with preeclampsia indicates a worsening condition that requires urgent medical attention.

D) A tearful client who is at 32 weeks of gestation and is experiencing irregular, frequent contractions:
While tearfulness and irregular, frequent contractions should be assessed, they are not typically indicators of an immediately life-threatening condition. In this scenario, the client's symptoms of epigastric pain and unresolved headache are more concerning and require immediate reporting to the healthcare provider.

A. Keep four side rails up while the client is in bed. B. Monitor the fetal heart rate (FHR) every hour. C. Check the cervix prior to analgesic administration D. Insert an indwelling urinary catheter.

Correct Answer is C

Explanation

A) Keep four side rails up while the client is in bed:
This action is not directly related to the care of a client in active labor. Side rails should be used based on the client's mobility status and fall risk, not specifically because the client is in labor.

B) Monitor the fetal heart rate (FHR) every hour:
Fetal heart rate monitoring is essential during labor, but hourly monitoring may not be frequent enough to detect changes in fetal status. Continuous or more frequent monitoring is typically indicated during active labor.

C) Check the cervix prior to analgesic administration:
This is an essential action as it ensures that analgesic administration is appropriate based on the client's cervical dilation. Administering analgesics when the cervix is fully dilated can increase the risk of neonatal depression. Therefore, assessing the cervix before administering analgesia is crucial.

D) Insert an indwelling urinary catheter:
Routine urinary catheterization during labor is not recommended unless medically necessary. There is no indication in the scenario that suggests the need for catheterization.

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A nurse is caring for a client who is in preterm labor at 32 weeks of gestation. The client asks the nurse. "Will my baby be okay?" Which of the following responses should the nurse offer?

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