A nurse is assessing a pregnant client at 28 weeks of gestation.

Which finding should the nurse prioritize as a potential sign of pre-term labor?

Hypoglycemia due to low glycogen stores.

Premature newborns have low glycogen stores and are at risk of developing hypoglycemia, which can cause seizures, brain damage, or death.

The nurse should monitor the blood glucose levels of the newborn and report any signs of hypoglycemia, such as jitteriness, lethargy, poor feeding, or temperature instability.

Choice A is wrong because increased bilirubin levels, not decreased, are a potential complication of prematurity.

Bilirubin is a waste product of red blood cell breakdown that can accumulate in the blood and cause jaundice, a yellowing of the skin and eyes.

Premature newborns have immature livers that cannot process bilirubin effectively and may need phototherapy to reduce the levels.

Choice B is wrong because decreased fat stores, not increased, are a potential complication of prematurity.

Fat stores provide insulation and energy for the newborn and help maintain body temperature.

Premature newborns have less subcutaneous fat and are prone to heat loss and cold stress, which can affect their metabolism and oxygen consumption.

Choice D is wrong because absence of mature lung surfactant, not presence, is a potential complication of prematurity.

Surfactant is a substance that reduces the surface tension of the alveoli and prevents them from collapsing during expiration.

Premature newborns have insufficient surfactant production and may develop respiratory distress syndrome, which is characterized by tachypnea, grunting, retractions, and cyanosis.

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.