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
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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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Nifedipine is a calcium channel blocker that is used to relax uterine contractions and postpone preterm labor.However, it can also lower blood pressure and cause side effects such as headache, dizziness, flushing, and palpitations.Therefore, it should be avoided in clients who have cardiac disease or other conditions that affect the heart function.
Choice A is wrong because asthma is not a contraindication for nifedipine.Nifedipine does not affect the airways or cause bronchospasm.
Choice B is wrong because diabetes mellitus is not a contraindication for nifedipine.Nifedipine does not affect blood glucose levels or insulin secretion.
Choice C is wrong because hypertension is not a contraindication for nifedipine.In fact, nifedipine can be used to treat high blood pressure as well as preterm labor.However, blood pressure should be monitored closely during nifedipine therapy to avoid hypotension.
Correct Answer is B
Explanation
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
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