A nurse is evaluating a client who is at 28 weeks of gestation and has pre-term labor.

Which of the following findings indicates that the client’s condition is improving?

Decreased frequency and intensity of contractions

Increased cervical dilation and effacement

Increased amount and color of vaginal discharge

Decreased fetal heart rate variability

Answer and Explanation

The Correct Answer is A

Decreased frequency and intensity of contractions indicates that the client’s condition is improving. Preterm labor occurs when regular contractions result in the opening of your cervix before 37 weeks of pregnancy.

If preterm labor can’t be stopped, your baby will be born early and may have health problems.

Choice B is wrong because increased cervical dilation and effacement means that the cervix is thinning and opening more, which are signs of labor progression.

Choice C is wrong because increased amount and color of vaginal discharge may indicate infection, bleeding, or rupture of membranes, which are complications of preterm labor.

Choice D is wrong because decreased fetal heart rate variability means that the baby’s heart rate is not changing much, which may indicate fetal distress or hypoxia. A normal fetal heart rate variability is between 6 and 25 beats per minute.

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Correct Answer is A

Explanation

History of urinary tract infections.According to the Mayo Clinic, untreated vaginal infections, such as urinary tract infections or sexually transmitted infections, are risk factors for preterm labor.

These infections can cause inflammation and irritation of the cervix, which can trigger contractions and cervical dilation.

Choice B is wrong because maternal age of 25 years is not a risk factor for preterm labor.In fact, women younger than 18 or older than 35 are more likely to have a preterm delivery.

Choice C is wrong because singleton pregnancy is not a risk factor for preterm labor.On the contrary, being pregnant with twins, triplets, or more (called "multiple gestations") is associated with a higher risk of preterm labor and birth.

Choice D is wrong because cervical length of 3 cm is not a risk factor for preterm labor.A short cervix (less than 2.5 cm) or a cervix that shortens in the second trimester instead of the third trimester is a risk factor for preterm delivery.A normal cervical length ranges from 3 to 5 cm during pregnancy.

A. Infection on speculum examination B. Bleeding on speculum examination C. Positive fetal fibronectin test (FFN) D. Normal fetal heart rate and activity

Correct Answer is A

Explanation

Infection on speculum examination.

Infection is a major cause of preterm labor and can lead to serious complications for the mother and the fetus.

Infection can be detected by a speculum examination that shows signs of inflammation, such as erythema, edema, discharge, or odor.

Infection can also be confirmed by laboratory tests, such as culture, gram stain, or polymerase chain reaction.Infection should be treated promptly with antibiotics and other supportive measures.

Choice B. Bleeding on speculum examination is wrong because bleeding is not a direct cause of preterm labor, but rather a sign of other conditions that may increase the risk of preterm labor, such as placenta previa, placental abruption, or cervical trauma.Bleeding should be evaluated further to determine the source and severity of the hemorrhage and to manage any complications.

Choice C. Positive fetal fibronectin test (FFN) is wrong because a positive FFN test indicates the presence of fetal fibronectin in the cervical or vaginal secretions, which is a marker of increased risk of preterm labor, but not a definitive marker.

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A nurse is evaluating a client who is at 28 weeks of gestation and has pre-term labor. Which of the following findings indicates that the client’s condition is improving?

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A nurse is evaluating a client who is at 28 weeks of gestation and has pre-term labor.

Which of the following findings indicates that the client’s condition is improving?