A nurse is preparing to perform an amniocentesis on a client who is at 27 weeks of gestation and has pre-term labor.
Which of the following actions should the nurse take before the procedure?
Administer tocolytic medication to stop contractions
Instruct the client to empty her bladder
Obtain informed consent from the client
Monitor fetal heart rate and activity
The Correct Answer is B
Instruct the client to empty her bladder. This is because a full bladder can interfere with the insertion of the needle and increase the risk of injury to the bladder or the uterus. Emptying the bladder also reduces discomfort during the procedure.
Choice A is wrong because administering tocolytic medication to stop contractions is not necessary before amniocentesis. Tocolytic medication can have side effects and should only be used when there is a clear indication of preterm labor.
Choice C is wrong because obtaining informed consent from the client is not a nursing action, but a medical one. The nurse can assist in providing information and answering questions, but the final consent should be obtained by the doctor who will perform the procedure.
Choice D is wrong because monitoring fetal heart rate and activity is not a specific action before amniocentesis, but a routine part of prenatal care. Fetal heart rate and activity can be affected by many factors, such as maternal position, fetal sleep cycle, or maternal blood sugar level.
Monitoring them before amniocentesis does not provide any useful information for the procedure.
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Correct Answer is C
Explanation
To promote fetal lung maturity.Betamethasone (Celestone) is a type of corticosteroid that can help reduce the risk of respiratory distress syndrome and other complications in preterm infants by accelerating the development of their lungs.It is recommended for pregnant women between 24 0/7 weeks and 36 6/7 weeks of gestation who are at risk of preterm delivery within 7 days.
Choice A is wrong because betamethasone does not suppress uterine contractions.
It has no effect on the cause of preterm labor.
Choice B is wrong because betamethasone does not prevent infection.
It may actually increase the risk of infection by suppressing the immune system.
Choice D is wrong because betamethasone does not reduce maternal blood pressure.
It may actually cause hypertension and hyperglycemia as side effects.
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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