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?

History of gestational diabetes.

History of cervical cerclage

History of recurrent urinary tract infections

History of assisted reproductive technology

Answer and Explanation

The Correct Answer is B

A cervical cerclage is a procedure that involves placing stitches around the cervix to prevent it from opening prematurely. This procedure is usually done for women who have a history of cervical insufficiency or a short cervix, which are risk factors for preterm labor.

Choice A is wrong because history of gestational diabetes is not a risk factor for preterm labor.

Gestational diabetes is a condition that causes high blood sugar during pregnancy and can affect the health of the mother and the baby, but it does not increase the risk of preterm labor.

Choice C is wrong because history of recurrent urinary tract infections (UTIs) is a risk factor for preterm labor.

UTIs are infections that affect the urinary system and can cause symptoms such as pain, burning, or frequent urination.

UTIs can also spread to the kidneys or the uterus and cause inflammation or infection that can trigger preterm labor.

Choice D is wrong because history of assisted reproductive technology (ART) is a risk factor for preterm labor.

ART refers to any medical procedure that helps with conception, such as in vitro fertilization (IVF).

ART can increase the risk of preterm labor because it can result in multiple gestations (twins, triplets, or more), which put more strain on the uterus and can cause it to contract prematurely. ART can also cause complications such as placenta previa or rupture of the uterus, which can lead to preterm labor.

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Correct Answer is C

Explanation

Assess fetal heart rate using a Doppler device.

This is because low back pain and pelvic pressure at 36 weeks of gestation may indicate preterm labor, which can affect the fetal well-being.Therefore, the nurse should assess the fetal heart rate as a priority to determine if the fetus is in distress or not.

Choice A is wrong because tocolytic medication is used to stop uterine contractions, not to relieve low back pain and pelvic pressure.Choice B is wrong because resting in a side-lying position may help with blood circulation and reduce supine hypotensive syndrome, but it does not address the possible cause of low back pain and pelvic pressure.Choice D is wrong because assessing vaginal discharge for any change may indicate infection, rupture of membranes, or cervical dilation, but it is not as urgent as assessing fetal heart rate.

Some interventions for preventing and treating low back pain and pelvic pressure during pregnancy include exercise, water-based exercise, acupuncture, osteomanipulative therapy, craniosacral therapy, and pelvic support belts.

However, these interventions should be discussed with the health care provider before starting them.

A. Administer magnesium sulfate intravenously B. Prepare for an emergency cesarean section C. Place the client in Trendelenburg position D. Administer antibiotics prophylactically

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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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a pregnant client at 36 weeks of gestation who reports low back pain and pelvic pressure. Which intervention should the nurse implement first?

Correct Answer is C

Explanation

Correct Answer is B

Explanation

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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?