A nurse is caring for a newborn who is 70 hours old in the newborn nursery.

Exhibits

For each assessment finding, click to specify if the finding is consistent with hypoglycemia or neonatal abstinence syndrome (NAS). Each finding may support more than one disease process.

Choice A rationale

Hydralazine is an antihypertensive medication used to manage hypertension, not preterm labor. Administering hydralazine would be inappropriate for a client in preterm labor unless she also has hypertension.

Choice B rationale

Preparing the client for immediate delivery based solely on a lecithin-to-sphingomyelin (L/S) ratio of 1: is premature. An L/S ratio of 2: or greater is generally indicative of fetal lung maturity. A ratio of 1: suggests lung immaturity, and interventions to promote lung maturity are indicated.

Choice C rationale

Infusing a bolus of IV fluids might be considered for hydration in preterm labor, but it does not directly address the issue of fetal lung immaturity indicated by the low L/S ratio. While hydration can help manage preterm contractions in some cases, it is not the primary intervention to improve fetal lung maturity.

Choice D rationale

Administering betamethasone, a corticosteroid, is the appropriate action for a client in preterm labor with a low L/S ratio (1:). Betamethasone crosses the placenta and stimulates the production of surfactant in the fetal lungs, accelerating lung maturity and reducing the risk of respiratory distress syndrome in the preterm infant. The typical dose is 12 mg IM, given in two doses 24 hours apart. .

Choice A rationale

Oral contraceptives primarily work by inhibiting ovulation through hormonal regulation. They do not inherently increase the risk of pelvic inflammatory disease (PID). In some cases, they may even offer a protective effect against PID by thickening cervical mucus, which can act as a barrier to ascending infections.

Choice B rationale

Frequent alcohol use can impair the immune system, potentially making an individual more susceptible to infections. However, it is not a direct cause of PID. PID is primarily caused by ascending infections, often sexually transmitted infections, rather than the direct effects of alcohol consumption.

Choice C rationale

Chlamydia trachomatis is a common sexually transmitted bacterium and a major cause of pelvic inflammatory disease. Untreated chlamydia infections can ascend from the cervix and uterus to the fallopian tubes and ovaries, leading to inflammation, scarring, and potentially long-term complications such as infertility and ectopic pregnancy.

Choice D rationale

Recurrent cystitis, an infection of the bladder, primarily affects the lower urinary tract. While urinary tract infections are common in women, they do not typically ascend to the reproductive organs and cause pelvic inflammatory disease. PID involves infection of the upper genital tract, including the uterus, fallopian tubes, and ovaries.