A nurse is caring for a client who is at 32 weeks of gestation and is in labor. Which of the following medications is contraindicated for this client?
Misoprostol
Folic acid
Nifedipine
Terbutaline sulfate
The Correct Answer is A
Choice A rationale: Misoprostol is a prostaglandin analog and is contraindicated for use during labor at 32 weeks of gestation as it can lead to uterine hyperstimulation, which may pose a risk to the preterm fetus.
Choice B rationale: Folic acid is a vitamin supplement and is not contraindicated during labor. However, it is typically taken earlier in pregnancy to prevent neural tube defects.
Choice C rationale: Nifedipine is a calcium channel blocker that may be used to suppress preterm labor, and it is not contraindicated at 32 weeks of gestation.
Choice D rationale: Terbutaline is a beta-adrenergic agonist that may be used to relax the uterine smooth muscles and inhibit preterm labor. It is not contraindicated at 32 weeks of gestation.
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Correct Answer is B
Explanation
Choice A rationale: Pain above the navel is not a specific indicator of labor and may be unrelated to the onset of labor.
Choice B rationale: Cervical dilation is a definitive sign of labor. It indicates that the cervix is opening to allow the baby's passage through the birth canal.
Choice C rationale: The presence of amniotic fluid in the vaginal vault (rupture of membranes) could indicate that the client's water has broken, but it does not confirm active labor. Labor can begin before or after the rupture of membranes.
Choice D rationale: Regular contractions are a typical sign of labor, but their frequency alone does not confirm active labor. Other signs, such as cervical dilation and effacement, are necessary to confirm active labor.
Correct Answer is D
Explanation
Choice A rationale: Stopping breastfeeding is not an appropriate response to breast engorgement. Continuing to breastfeed frequently and effectively can help relieve the engorgement and ensure adequate milk supply.
Choice B rationale: While frequent breastfeeding is beneficial for both the baby and mother, this statement does not directly address breast engorgement.
Choice C rationale: Wearing a supportive bra during the daytime can actually help reduce breast engorgement and discomfort by providing gentle pressure and support to the breasts.
Choice D rationale: Breast engorgement is a common issue for breastfeeding mothers, especially during the early days after delivery. Applying cold compresses to the breasts before each feeding can help reduce swelling and discomfort associated with engorgement, making it easier for the baby to latch onto the breast.
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