A nurse is caring for a client who is at 33 weeks of gestation and has pre-term labor.

The client reports a sudden gush of fluid from her vagina.

Which of the following actions should the nurse take first?

Tocolytics are a category of drugs used to delay the labor process.These may be used in situations when a pregnant person begins showing signs of preterm labor —which is any time before 37 weeks of completed pregnancy.Tocolytics may help delay labor by two to seven days.

Some possible explanations for the other choices are:

• Choice A. Administering intravenous fluids.

This is not a correct answer because intravenous fluids are not effective in suppressing uterine contractions.They may be used to correct dehydration or electrolyte imbalance, which can sometimes trigger preterm labor, but they are not a primary intervention for preterm labor.

• Choice C. Administering corticosteroids.

This is not a correct answer because corticosteroids are not tocolytics.They do not stop or slow down uterine contractions, but they help accelerate fetal lung maturity and reduce the risk of neonatal respiratory distress syndrome and other complications of prematurity.

Corticosteroids are often given along with tocolytics, but they have a different function and mechanism of action.

• Choice D. Administering antibiotics.

This is not a correct answer because antibiotics are not tocolytics.They may be used to treat infections that can cause or complicate preterm labor, such as chorioamnionitis or group B streptococcus, but they do not directly affect uterine contractions.

Antibiotics may be given along with tocolytics, but they have a different function.

Instruct the client to empty her bladder.This is because a full bladder can interfere with the insertion of the needle and increase the risk of injury to the bladder or the uterus.Emptying the bladder also reduces discomfort during the procedure.

Choice A is wrong because administering tocolytic medication to stop contractions is not necessary before amniocentesis.Tocolytic medication can have side effects and should only be used when there is a clear indication of preterm labor.

Choice C is wrong because obtaining informed consent from the client is not a nursing action, but a medical one.The nurse can assist in providing information and answering questions, but the final consent should be obtained by the doctor who will perform the procedure.

Choice D is wrong because monitoring fetal heart rate and activity is not a specific action before amniocentesis, but a routine part of prenatal care.Fetal heart rate and activity can be affected by many factors, such as maternal position, fetal sleep cycle, or maternal blood sugar level.

Monitoring them before amniocentesis does not provide any useful information for the procedure.