A nurse is caring for a client who is receiving magnesium sulfate for pre-term labor.

Which of the following assessments should the nurse perform to evaluate the therapeutic effect of the medication?

Prepare for an emergency cesarean section.This is because the client has pre-term labor that has not responded to tocolytic therapy, which are drugs that are used to delay delivery for a short time.The client’s cervix is dilated to 4 cm and she is experiencing regular contractions every 3 minutes, which are signs of active labor.The baby is at 33 weeks of gestation, which is premature and may have complications such as respiratory distress syndrome or bleeding in the brain.

Therefore, the client needs an emergency cesarean section to deliver the baby as soon as possible and prevent further risks.

Choice A is wrong because administering magnesium sulfate intravenously is a type of tocolytic therapy that the client has already failed.Magnesium sulfate may also have side effects such as nausea, vomiting, flushing, headache, and muscle weakness.

Choice C is wrong because placing the client in Trendelenburg position, which is lying on the back with the feet elevated above the head, is not recommended for preterm labor.This position may increase the risk of aspiration, decrease cardiac output, and impair gas exchange.

Choice D is wrong because administering antibiotics prophylactically is not indicated for preterm labor unless there is evidence of infection in the uterus or membranes.

Antibiotics may also cause allergic reactions or bacterial resistance

True labor contractions cause cervical dilation and effacement.

This means that the cervix opens up and thins out to prepare for the baby’s passage through the birth canal.

Cervical changes can be measured by a pelvic exam.

Choice A is wrong because true labor contractions are regular and do not subside with rest.False labor contractions are irregular and may stop when you change position or activity level.

Choice B is wrong because false labor contractions are usually felt in the front of the abdomen, not in the lower back.True labor contractions may start in the back and radiate to the abdomen.

Choice D is wrong because false labor contractions do not increase in intensity with ambulation.True labor contractions may become stronger and closer together when you walk.

Normal ranges for cervical dilation and effacement vary depending on the stage of labor, but generally, full dilation is 10 cm and full effacement is 100%.