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

Which of the following factors increases the risk of pre-term labor?

A. Referral to community services for support.

Referral to community services for support is an important part of the discharge plan for a client in preterm labor.Community services can provide education, counseling, home visits, and other resources to help the client cope with preterm labor and prevent complications.

B. Encouragement to smoke in moderation.Statement is wrong because smoking is harmful for the unborn baby and can increase the risk of preterm labor.Smoking should be avoided completely during pregnancy and the client should be advised to quit or seek help to quit.

C. Instructions for heavy lifting and strenuous exercise.Statement is wrong because heavy lifting and strenuous exercise can trigger contractions and worsen preterm labor.The client should be instructed to rest as much as possible and avoid activities that may cause uterine irritation or bleeding.

D. Recommendation to avoid kangaroo care.Statement is wrong because kangaroo care, or skin-to-skin contact with the baby, is beneficial for both the mother and the baby after birth.Kangaroo care can help regulate the baby’s temperature, heart rate, breathing, and blood sugar levels, as well as promote bonding, breastfeeding, and infection prevention.The client should be encouraged to practice kangaroo care as soon as possible after delivery.

Creatinine clearance.

Indomethacin is a nonsteroidal anti-inflammatory drug (NSAID) that inhibits prostaglandin synthesis and suppresses uterine contractions.However, it can also causerenal failurein the fetus and the mother by reducing renal blood flow and glomerular filtration rate.

Therefore, the nurse should monitor the creatinine clearance, which is a measure of renal function, while the client is receiving this medication.

Choice A is wrong because indomethacin does not affect platelet count or coagulation.

Choice C is wrong because indomethacin does not affect liver function tests.

Choice D is wrong because indomethacin does not affect blood glucose levels.

Normal ranges for creatinine clearance are 88-128 mL/min for women and 97-137 mL/min for men.Normal ranges for platelet count are 150,000-450,000 cells/mm3.

Normal ranges for liver function tests vary depending on the specific test, but some common ones are: alanine aminotransferase (ALT) 7-55 U/L, aspartate aminotransferase (AST) 8-48 U/L, alkaline phosphatase (ALP) 45-115 U/L, total bilirubin 0.1-1.2 mg/dL.