A nurse is caring for a client who is at 26 weeks of gestation and has PPROM.

Which of the following medications should the nurse expect to administer to the client? (Select all that apply.)

Betamethasone

Magnesium sulfate

Ampicillin

Oxytocin

Indomethacin

Answer and Explanation

Correct Answer : A,B,C

Betamethasone, magnesium sulfate and ampicillin are medications that can be given to a client who has PPROM.

• Betamethasone is a corticosteroid that can help the baby’s lungs mature faster and reduce the risk of respiratory distress syndrome. It is usually given between 24 and 34 weeks of gestation.

• Magnesium sulfate is a tocolytic that can prevent preterm labor and reduce the risk of intraventricular hemorrhage and cerebral palsy in the baby. It is usually given for 24 to 48 hours after PPROM.

• Ampicillin is an antibiotic that can prevent or treat infection in the amniotic fluid, which is a common complication of PPROM. It can also prolong the latency period (the time between PPROM and delivery) and improve neonatal outcomes.

Normal ranges for gestational age are:

• 37 to 42 weeks for term pregnancy

• 34 to 36 weeks for late preterm pregnancy

• 32 to 33 weeks for moderate preterm pregnancy

• 28 to 31 weeks for very preterm pregnancy

• Less than 28 weeks for extremely preterm pregnancy

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Correct Answer is D

Explanation

The nurse should perform all of the assessments listed to monitor for magnesium toxicity.

Magnesium sulfate is a drug that is given to prevent preterm labor by relaxing the uterine muscle.

However, it can also cause serious side effects such as weakness, low blood pressure, respiratory paralysis, and cardiac problems if the level of magnesium in the blood is too high.

The normal level of magnesium in the blood is about 1.5-2.5 mEq/L.Symptoms of toxicity may appear when the level reaches 4 mEq/L or higher.

A. Decreased fetal movements B. Increased amniotic fluid index C. Decreased maternal pulse rate D. Increased maternal leukocyte count

Correct Answer is B

Explanation

Increased amniotic fluid index indicates a positive outcome of antibiotic therapy for a client who has PPROM at 28 weeks of gestation.Antibiotics are used to prevent or treat infection and prolong pregnancy in women with PPROM.Infection can cause oligohydramnios (low amniotic fluid) which can lead to fetal complications such as cord compression, pulmonary hypoplasia and limb deformities.

Therefore, an increased amniotic fluid index suggests that the infection has been reduced or resolved and the risk of preterm birth has been lowered.

Normal ranges for amniotic fluid index are 5 to 25 cm.Normal ranges for maternal pulse rate are 60 to 100 beats per minute.Normal ranges for maternal leukocyte count are 4.5 to 11 x 10^9/L.

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A nurse is caring for a client who is at 26 weeks of gestation and has PPROM. Which of the following medications should the nurse expect to administer to the client? (Select all that apply.)

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client with PROM who is receiving magnesium sulfate as a tocolytic agent. Which of the following assessments should the nurse perform to monitor for magnesium toxicity?

Correct Answer is D

Explanation

A nurse is evaluating the effectiveness of antibiotic therapy for a client who has PPROM at 28 weeks of gestation. Which of the following findings indicates a positive outcome?

Correct Answer is B

Explanation

A nurse is caring for a client with PPROM who is experiencing uterine contractions and signs of chorioamnionitis. The nurse anticipates that the health care provider will order which of the following interventions?

A nurse is providing discharge instructions to a client who has PPROM at 30 weeks of gestation and is on home bed rest. Which of the following instructions should the nurse include?

A nurse is teaching a client who is at 30 weeks of gestation and has PROM about the signs and symptoms of infection. Which of the following should the nurse include in the teaching? (Select all that apply.)

A nurse is caring for a client who has PPROM at 32 weeks of gestation and is receiving antibiotics prophylactically. The nurse should monitor the client for which of the following signs of infection?

A nurse is providing discharge instructions to a client who experienced PROM at 20 weeks of gestation and is on home bed rest. Which of the following instructions should the nurse include?

A nurse is teaching a pregnant woman who is at risk for pre-term labor. Which of the following activities should the nurse instruct the woman to avoid?

A nurse is preparing to administer betamethasone to a client who has PPROM at 26 weeks of gestation. Which of the following statements by the nurse is appropriate?

A nurse is assessing a client with PROM who is at 37 weeks of gestation. The nurse notes that the client has a foul-smelling vaginal discharge and a temperature of 38.2°C (100.8°F). The nurse recognizes these findings as indicative of:

A nurse is caring for a client who is at 26 weeks of gestation and has PPROM.

Which of the following medications should the nurse expect to administer to the client? (Select all that apply.)