A nurse is preparing to administer liquid mycostatin 600,000 units PO TID. Available is mycostatin 100,000 units/mL. How many m. should the

nurse administer per dose? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

Choice A Reason:
Tocolytic therapy is not indicated for a client with a post-term pregnancy. Tocolytics are medications used to suppress premature labor, and a pregnancy at 42 weeks is considered post-term, not preterm.

Choice B Reason:
Braxton-Hicks contractions are normal occurrences during pregnancy and do not indicate preterm labor. They are often referred to as "false labor" because they do not lead to cervical dilation or effacement. Therefore, tocolytic therapy is not necessary.

Choice C Reason:
Administering tocolytic therapy in the case of fetal death is not appropriate. Tocolytics are used to delay preterm labor to allow for fetal maturation or to prolong pregnancy to administer corticosteroids for fetal lung development, which is not applicable in this scenario.

Choice D Reason:
Tocolytic therapy is appropriate for a client experiencing preterm labor at 26 weeks of gestation. The goal of tocolytic therapy is to delay delivery to allow for the administration of corticosteroids to accelerate fetal lung maturity or to transfer the client to a facility equipped for premature infants.

Choice A reason:
Placental insufficiency is a significant cause of a newborn being small for gestational age. It occurs when the placenta cannot deliver an adequate supply of nutrients and oxygen to the fetus. This condition can result from several factors, including maternal hypertension, diabetes, and certain infections. Placental insufficiency leads to intrauterine growth restriction (IUGR), which is often diagnosed when a fetus's estimated weight is below the 10th percentile for its gestational age¹². The normal range for fetal growth varies, but a key indicator is the consistent growth along a certain percentile line on growth charts.

Choice B reason:
Fetal hyperinsulinemia is typically associated with mothers who have diabetes. Insulin acts as a growth hormone; thus, excessive insulin can lead to macrosomia, where the newborn is larger than normal for the gestational age, not smaller². Therefore, fetal hyperinsulinemia is not a likely cause of SGA.

Choice C reason:
Preterm delivery can result in a newborn being small for gestational age simply due to the fact that the baby is born before reaching full term and having the opportunity to achieve the expected in-utero growth. However, being born preterm does not necessarily mean the infant is SGA; it means the infant is smaller than full-term babies because they have had less time to grow in utero¹.

Choice D reason:
Perinatal asphyxia refers to a lack of oxygen to the fetus during the time immediately before, during, or after birth. While it can lead to various complications and is a serious condition, it is not a direct cause of a newborn being small for gestational age. Perinatal asphyxia can occur in infants of any gestational age or size².