A nurse is reviewing the medical record of a client who is at 34 weeks of gestation and has pre-term labor.

Which of the following findings is a risk factor for pre-term labor?

The client should not limit their physical activity and rest as much as possible, unless advised by their provider.Excessive rest and inactivity can increase the risk of blood clots and decrease blood circulation, which can affect the placenta and the fetus.The client should follow the recommended guidelines for physical activity during pregnancy, unless they have a medical condition that requires bed rest or reduced activity.

Choice A is wrong because smoking and drinking alcohol during pregnancy are known risk factors for preterm labor and birth.Smoking can reduce blood flow to the placenta and affect fetal growth and development, while alcohol can cause fetal alcohol spectrum disorders and other complications.

Choice B is wrong because reporting any vaginal bleeding or fluid leakage to the provider is important to prevent or treat preterm labor and birth.Bleeding can indicate placenta previa or placental abruption, which are serious conditions that can cause premature delivery or fetal distress.Fluid leakage can indicate rupture of membranes, which can increase the risk of infection and preterm labor.

Choice D is wrong because drinking plenty of fluids and eating a balanced diet are beneficial for the health of the mother and the fetus.Dehydration can cause uterine contractions and trigger preterm labor, while malnutrition can affect fetal growth and development.A balanced diet can also help prevent or manage conditions like diabetes, high blood pressure, and anemia, which are risk factors for preterm labor and birth.

This is because assessing fetal heart rate is the most important action to take first when a client has prelabor rupture of membranes (PROM) at 34 weeks of gestation and oligohydramnios.Fetal heart rate can indicate fetal well-being, distress, or infection.Oligohydramnios can increase the risk of umbilical cord compression and fetal hypoxia.

Choice A is wrong because administering IV fluids is not the first priority in this situation.IV fluids may be given to prevent dehydration, enhance uterine blood flow, or augment labor, but they are not as urgent as assessing fetal heart rate.

Choice B is wrong because obtaining a urine specimen is not the first priority in this situation.A urine specimen may be obtained to check for infection, proteinuria, or glucose levels, but they are not as urgent as assessing fetal heart rate.

Choice D is wrong because inserting an indwelling urinary catheter is not the first priority in this situation.An indwelling urinary catheter may be inserted to monitor fluid balance, prevent bladder distension, or reduce the risk of infection, but they are not as urgent as assessing fetal heart rate.

Normal ranges for fetal heart rate are 110 to 160 beats per minute.Oligohydramnios is defined as an amniotic fluid index of less than 5 cm.