A nurse is reviewing the ultrasound report of a client who is at 31 weeks of gestation and has pre-term labor.
Which of the following findings indicates oligohydramnios?
Amniotic fluid index of 4 cm
Amniotic fluid index of 8 cm
Amniotic fluid index of 12 cm
Amniotic fluid index of 16 cm
The Correct Answer is A
Amniotic fluid index of 4 cm indicates oligohydramnios, which means too little amniotic fluid. This can cause fetal growth restriction, cord compression, and congenital anomalies.
Choice B is wrong because amniotic fluid index of 8 cm is within the normal range of 5 to 25 cm.
Choice C is wrong because amniotic fluid index of 12 cm is also within the normal range and close to the median value of 14 cm.
Choice D is wrong because amniotic fluid index of 16 cm is also within the normal range and does not indicate oligohydramnios.
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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
Correct Answer is C
Explanation
Corticosteroids are given to pregnant women who are at risk of preterm labor to help mature the lungs of the fetus and reduce the risk of respiratory distress syndrome and other complications.Corticosteroids also have a protective effect on the brain and reduce the risk of bleeding and cerebral palsy.
Choice A is wrong because administering intravenous fluids is not a specific intervention to address possible outcomes and complications of preterm labor.Intravenous fluids may be given to correct dehydration or electrolyte imbalance, but they do not prevent or treat preterm labor.
Choice B is wrong because administering tocolytics is an intervention to delay preterm labor, not to address possible outcomes and complications.
Tocolytics are drugs that inhibit uterine contractions and prolong pregnancy for a short period of time, usually 24 to 48 hours, to allow for the administration of corticosteroids or the transfer of the mother to a facility with neonatal intensive care.
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