A nurse is caring for several clients.The nurse should recognize that it is appropriate to administer tocolytic therapy to which of the following clients?
A client who has a post-term pregnancy at 42 weeks of gestation.
A client who is dilated to 7 cm and experiencing contractions every 3-4 minutes.
A client having Braxton-Hicks contractions at 36 weeks of gestation.
A client who is experiencing preterm labor at 32 weeks of gestation.
The Correct Answer is D
Choice A rationale
A post-term pregnancy at 42 weeks of gestation does not require tocolytic therapy. Tocolytics are used to stop preterm labor, not to manage full-term or post-term pregnancies.
Choice B rationale
A client who is dilated to 7 cm and experiencing contractions every 3-4 minutes is in active labor, and tocolytic therapy is not appropriate in this advanced stage of labor.
Choice C rationale
Braxton-Hicks contractions at 36 weeks of gestation are typically harmless and do not require tocolytic therapy. These contractions are usually irregular and do not lead to labor.
Choice D rationale
A client who is experiencing preterm labor at 32 weeks of gestation is an appropriate candidate for tocolytic therapy. The goal is to delay labor to allow for further fetal development and possibly administer corticosteroids to enhance fetal lung maturity.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
A temperature of 37.8°C (100.3°F) is a low-grade fever that does not typically indicate a serious issue in the context of epidural analgesia during labor. It should be monitored, but it's not immediately concerning.
Choice B rationale
Generalized itching can be a common side effect of epidural analgesia due to the opioids used. It should be monitored and managed, but it does not typically require immediate physician notification.
Choice C rationale
Weakness of the lower extremities can be expected with epidural analgesia as it causes a loss of sensation and muscle control. This should be monitored, but it is not typically an emergency.
Choice D rationale
Fetal bradycardia is a serious concern that must be reported to the physician immediately. It can indicate fetal distress and requires urgent evaluation and intervention to ensure the well-being of the baby. .
Correct Answer is D
Explanation
Choice A rationale
Ibuprofen IM injection is not typically used for labor pain due to its limited effectiveness for severe pain and potential side effects on the mother and fetus.
Choice B rationale
Pudendal block provides pain relief during the second stage of labor, particularly for episiotomy or forceps delivery. It is not typically used during the active phase of labor dilation.
Choice C rationale
Spinal block is often used for cesarean sections or late-stage labor but is not commonly used for pain management during early or active labor due to its short duration of action.
Choice D rationale
Epidural analgesia is the most effective and widely used method for pain management during active labor. It provides continuous pain relief by administering medication through a catheter placed in the epidural space.
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