A nurse is assessing a client for pre-term labor.

Which of the following assessments should the nurse prioritize?

Performing a speculum examination of the vagina and cervix.

This is because a speculum examination can help determine the presence of cervical dilation, effacement, or infection, which are signs of pre-term labor.

A speculum examination can also detect the presence of fetal fibronectin, which is a protein that indicates an increased risk of pre-term delivery.

Choice A is wrong because obtaining a detailed history of previous pregnancies is not a priority assessment for pre-term labor.

While it can provide some information about the client’s risk factors, it does not indicate the current status of the pregnancy or the cervix.

Choice B is wrong because checking the fetal heart rate and activity is not a priority assessment for pre-term labor.

While it can provide some information about the fetal well-being, it does not indicate the presence or absence of contractions or cervical changes.

Choice D is wrong because performing laboratory tests, such as urine culture, is not a priority assessment for pre-term labor.

While it can help identify possible infections that may contribute to pre-term labor, it does not provide immediate results or indicate the current status of the cervix.

Monitoring cervical changes.

This is because cervical changes indicate the progress of labor and the risk of preterm delivery.

Preterm labor is defined as regular uterine contractions with cervical dilation and effacement before 37 weeks of gestation.

The nurse should assess the cervical length, dilation, effacement, and position frequently to determine the need for interventions to stop or delay labor.

Choice A is wrong because monitoring vital signs is not specific to fetal well-being.

Vital signs can reflect maternal health, infection, or complications, but they do not directly measure fetal status.

Choice C is wrong because monitoring fluid intake and output is not specific to fetal well-being.

Fluid balance can affect maternal hydration, electrolytes, and blood pressure, but it does not directly measure fetal status.

Choice D is wrong because monitoring maternal preference is not specific to fetal well-being.

Maternal preference can affect the comfort, satisfaction, and coping of the mother, but it does not directly measure fetal status.