A nurse is administering betamethasone to a client who is at risk for pre-term labor at 30 weeks of gestation.

Which of the following outcomes should the nurse monitor for in the newborn?

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

“This medication can cause premature closure of your baby’s ductus arteriosus.”

Indomethacin is a NSAID that can prevent the synthesis of prostaglandins, which are involved in preterm contractions.However, it can also cause constrictive effects on the fetal ductus arteriosus, which can lead to cardiac complications and oligohydramnios.The dosage and duration of indomethacin treatment should be carefully monitored.

Choice B is wrong because indomethacin does not increase the risk of postpartum hemorrhage.In fact, it may reduce the risk of bleeding by inhibiting platelet aggregation.

Choice C is wrong because indomethacin does not cause jaundice in the baby.

Jaundice is caused by high levels of bilirubin in the blood, which can be due to various factors such as blood group incompatibility, infection, or liver problems.

Choice D is wrong because indomethacin does not increase blood pressure during labor.It may actually lower blood pressure by dilating blood vessels.

Normal ranges for indomethacin dosage are 25 to 50 mg orally every 6 hours or 100 mg rectally every 12 hours for up to 48 hours.

Normal ranges for fetal ductus arteriosus diameter are 1.5 to 4 mm before 28 weeks of gestation and 1 to 3 mm after 28 weeks of gestation.