A client in pre-term labor is being discharged from the hospital.

What should the nurse include in the client's discharge plan?

Referral to community services for support

Encouragement to smoke in moderation

Instructions for heavy lifting and strenuous exercise

Recommendation to avoid kangaroo care

Answer and Explanation

The Correct Answer is A

A. Referral to community services for support.

A client in preterm labor who is being discharged from the hospital needs to have a discharge plan that includes education, follow-up care, and support services. A referral to community services for support can help the client cope with the stress and anxiety of preterm labor, access resources such as home health care or social workers, and prevent complications or recurrence of preterm labor.

B. Encouragement to smoke in moderation is wrong because smoking is harmful for both the mother and the baby.

Smoking can increase the risk of preterm labor, low birth weight, placental abruption, and sudden infant death syndrome (SIDS). Smoking should be avoided completely during pregnancy and after delivery.

C. Instructions for heavy lifting and strenuous exercise is wrong because these activities can trigger uterine contractions and increase the risk of preterm labor.

A client in preterm labor should rest as much as possible and avoid physical exertion. The client should also avoid sexual intercourse, which can stimulate the cervix and cause bleeding or infection.

D. Recommendation to avoid kangaroo care is wrong because kangaroo care is a method of holding a newborn skin-to-skin with the mother or father.

Kangaroo care can have many benefits for preterm babies, such as improving temperature regulation, breathing, heart rate, feeding, bonding, and growth. Kangaroo care can also reduce stress and pain for both the baby and the parent.

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Correct Answer is A

Explanation

Assess fetal heart rate and activity.

The nurse should identify that a client who reports a sudden gush of fluid from her vagina is at risk forpremature rupture of membranes (PROM), which can lead toinfection,cord prolapse, andfetal distress.Therefore, the priority action is to assess the fetal heart rate and activity to monitor for signs of hypoxia or distress.

Choice B is wrong because performing a nitrazine test on the fluid is not the first action.A nitrazine test can confirm the presence of amniotic fluid by detecting its alkaline pH, but it is not as urgent as assessing the fetal well-being.

Choice C is wrong because administering oxytocin (Pitocin) IV infusion is contraindicated in this situation.Oxytocin is used to induce or augment labor, but it can causeuterine hyperstimulation,fetal distress, andplacental abruptionif given to a client who has PROM.

Choice D is wrong because placing the client in Trendelenburg position is not recommended for a client who has PROM.Trendelenburg position can increase the risk ofcord prolapseandaspirationin this situation.

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 client in pre-term labor is being discharged from the hospital. What should the nurse include in the client's discharge plan?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is at 33 weeks of gestation and has pre-term labor. The client reports a sudden gush of fluid from her vagina. Which of the following actions should the nurse take first?

Correct Answer is A

Explanation

Correct Answer is B

Explanation

A nurse is assessing a pre-term newborn who was born at 28 weeks of gestation. Which of the following findings indicates a possible diagnosis of respiratory distress syndrome (RDS)?

A nurse is reviewing the medication history of a client who is in pre-term labor and has a history of peptic ulcer disease. The nurse should recognize that which of the following medications is contraindicated for this client?

A nurse is providing discharge instructions to a client who had pre-term labor at 32 weeks of gestation and was prescribed bed rest at home. Which of the following statements by the client indicates an understanding of the teaching?

A nurse is caring for a client who is in pre-term labor. Which of the following maternal complications is most likely to occur due to prolonged bed rest?

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?

A nurse is planning care for a pre-term newborn who has a diagnosis of intraventricular hemorrhage (IVH). Which of the following interventions should the nurse include in the plan?

A nurse is teaching a client who is at 25 weeks of gestation and has pre-term labor about the purpose and side effects of magnesium sulfate therapy. Which of the following statements by the client indicates an understanding of the teaching?

A nurse is caring for a client who is receiving magnesium sulfate for pre-term labor. Which of the following assessments should the nurse perform to evaluate the therapeutic effect of the medication?

A client in pre-term labor is being discharged from the hospital.

What should the nurse include in the client's discharge plan?