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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Correct Answer is B
Explanation
Tocolytics are a category of drugs used to delay the labor process.These may be used in situations when a pregnant person begins showing signs of preterm labor —which is any time before 37 weeks of completed pregnancy.Tocolytics may help delay labor by two to seven days.
Some possible explanations for the other choices are:
• Choice A. Administering intravenous fluids.
This is not a correct answer because intravenous fluids are not effective in suppressing uterine contractions.They may be used to correct dehydration or electrolyte imbalance, which can sometimes trigger preterm labor, but they are not a primary intervention for preterm labor.
• Choice C. Administering corticosteroids.
This is not a correct answer because corticosteroids are not tocolytics.They do not stop or slow down uterine contractions, but they help accelerate fetal lung maturity and reduce the risk of neonatal respiratory distress syndrome and other complications of prematurity.
Corticosteroids are often given along with tocolytics, but they have a different function and mechanism of action.
• Choice D. Administering antibiotics.
This is not a correct answer because antibiotics are not tocolytics.They may be used to treat infections that can cause or complicate preterm labor, such as chorioamnionitis or group B streptococcus, but they do not directly affect uterine contractions.
Antibiotics may be given along with tocolytics, but they have a different function.
Correct Answer is B
Explanation
Lying on one’s back with knees bent while using the monitor is not recommended for women at risk of preterm labor, as it can put pressure on the inferior vena cava, a major vein leading back to the heart.This can cause low blood pressure and reduce blood flow to the uterus and the baby.A better position is to lie on one’s side with a pillow at the back for support.
Choice A is correct because emptying the bladder before applying the monitor can reduce interference from urine contractions and make the readings more accurate.
Choice C is correct because pressing the event marker every time one feels a contraction can help record the frequency and duration of uterine activity.
Choice D is correct because using the monitor for at least 1 hour twice a day can provide sufficient data on uterine contractions and help detect early signs of preterm labor.
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