A nurse is reviewing the history of a client who is pregnant.
Which of the following clinical data indicates the client is at risk for preterm delivery?

Previous delivery at 37 weeks gestation

Previous delivery of a newborn weighing 2.5 kg (5.5 lb)

Previous reactive non-stress test

Previous cervical cerclage

Answer and Explanation

The Correct Answer is D

Choice A rationale
A previous delivery at 37 weeks gestation does not necessarily indicate a risk for preterm delivery. Preterm delivery is defined as delivery before 37 weeks of gestation.
Choice B rationale
A previous delivery of a newborn weighing 2.5 kg (5.5 lb) does not indicate a risk for preterm delivery. Low birth weight can be a result of preterm delivery, but it can also be due to other factors such as intrauterine growth restriction.
Choice C rationale
A previous reactive non-stress test does not indicate a risk for preterm delivery. A reactive non-stress test is a positive sign of fetal well-being.
Choice D rationale
A previous cervical cerclage indicates a risk for preterm delivery. Cervical cerclage is a procedure performed to prevent preterm birth in women with a history of preterm birth and who have a short cervix.

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Correct Answer is []

Explanation

Endometritis: The client’s symptoms such as general malaise, chills, decreased appetite, elevated white blood cell count, fever, a boggy and tender uterus, and foul-smelling lochia suggest that she is most likely experiencing endometritis, an inflammation of the inner lining of the uterus, typically due to infection.
Actions to take: The nurse should administer the prescribed antibiotics to treat the infection. The nurse should also educate the client on proper perineal hygiene to prevent further infection.
Parameters to monitor: The nurse should monitor the client’s temperature to assess for fever, which can be a sign of infection. The nurse should also monitor the amount and odor of the client’s lochia, as changes can indicate worsening infection.

A. Prepare the patient for a pudendal nerve block B. Apply hydrogel pads to the perineum every 4 hours C. Encourage the patient to apply a warm pack to the perineum for discomfort D. Place a witch hazel pad on the patient’s perineal pad after each voiding

Correct Answer is D

Explanation

Choice A rationale
A pudendal nerve block is not typically used for postpartum perineal pain management. It is more commonly used during labor to relieve pain in the perineum and vagina.
Choice B rationale
While hydrogel pads can provide cooling relief, they are not typically used for third-degree perineal lacerations. These types of lacerations often require more intensive interventions.
Choice C rationale

Applying a warm pack to the perineum can help with discomfort, but it is not the primary intervention for a third-degree perineal laceration.
Choice D rationale
Witch hazel pads are often recommended for postpartum perineal care. They can provide relief from soreness, reduce inflammation, and promote healing.

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A nurse is reviewing the history of a client who is pregnant. Which of the following clinical data indicates the client is at risk for preterm delivery?

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Correct Answer is []

Explanation

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Correct Answer is D

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A nurse is reviewing the history of a client who is pregnant.
Which of the following clinical data indicates the client is at risk for preterm delivery?