A nurse is caring for a client who is receiving magnesium sulfate for pre-term labor.

Which of the following assessments should the nurse perform to evaluate the therapeutic effect of the medication?

Assess fetal heart rate using a Doppler device.

This is because low back pain and pelvic pressure at 36 weeks of gestation may indicate preterm labor, which can affect the fetal well-being.Therefore, the nurse should assess the fetal heart rate as a priority to determine if the fetus is in distress or not.

Choice A is wrong because tocolytic medication is used to stop uterine contractions, not to relieve low back pain and pelvic pressure.Choice B is wrong because resting in a side-lying position may help with blood circulation and reduce supine hypotensive syndrome, but it does not address the possible cause of low back pain and pelvic pressure.Choice D is wrong because assessing vaginal discharge for any change may indicate infection, rupture of membranes, or cervical dilation, but it is not as urgent as assessing fetal heart rate.

Some interventions for preventing and treating low back pain and pelvic pressure during pregnancy include exercise, water-based exercise, acupuncture, osteomanipulative therapy, craniosacral therapy, and pelvic support belts.

However, these interventions should be discussed with the health care provider before starting them.

A. Referral to community services for support.

A client in preterm labor who is being discharged from the hospital needs to have a discharge plan that includes education, follow-up care, and support services.A referral to community services for support can help the client cope with the stress and anxiety of preterm labor, access resources such as home health care or social workers, and prevent complications or recurrence of preterm labor.

B. Encouragement to smoke in moderation is wrong because smoking is harmful for both the mother and the baby.

Smoking can increase the risk of preterm labor, low birth weight, placental abruption, and sudden infant death syndrome (SIDS).Smoking should be avoided completely during pregnancy and after delivery.

C. Instructions for heavy lifting and strenuous exercise is wrong because these activities can trigger uterine contractions and increase the risk of preterm labor.

A client in preterm labor should rest as much as possible and avoid physical exertion.The client should also avoid sexual intercourse, which can stimulate the cervix and cause bleeding or infection.

D. Recommendation to avoid kangaroo care is wrong because kangaroo care is a method of holding a newborn skin-to-skin with the mother or father.

Kangaroo care can have many benefits for preterm babies, such as improving temperature regulation, breathing, heart rate, feeding, bonding, and growth.Kangaroo care can also reduce stress and pain for both the baby and the parent.