A nurse is caring for a pregnant client at 36 weeks of gestation who reports low back pain and pelvic pressure.

Which intervention should the nurse implement first?

Administer a dose of tocolytic medication

Encourage the client to rest in a side-lying position

Assess fetal heart rate using a Doppler device

Assess vaginal discharge for any change

Answer and Explanation

The Correct Answer is C

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.

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Correct Answer is B

Explanation

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.

A. Ultrasound B. Blood count C. Urine culture D. Amniocentesis

Correct Answer is A

Explanation

Ultrasound.

An ultrasound can help determine the gestational age, fetal growth, placental location, and amniotic fluid volume of the fetus.

These factors can affect the risk of pre-term labor and delivery.

An ultrasound can also detect cervical changes that may indicate pre-term labor.

Choice B is wrong because a blood count is not specific for pre-term labor.

It may be done to check for anemia, infection, or other conditions that may affect the pregnancy, but it does not directly assess the risk of pre-term labor.

Choice C is wrong because a urine culture is not specific for pre-term labor.

It may be done to check for urinary tract infection, which can cause pre-term labor, but it does not directly assess the risk of pre-term labor.

Choice D is wrong because an amniocentesis is not usually done for pre-term labor.

It may be done to check for fetal lung maturity, chromosomal abnormalities, or infections, but it is an invasive procedure that carries some risks and complications.

It does not directly assess the risk of pre-term labor.

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A nurse is caring for a pregnant client at 36 weeks of gestation who reports low back pain and pelvic pressure. Which intervention should the nurse implement first?

A nurse is caring for a pregnant client at 36 weeks of gestation who reports low back pain and pelvic pressure.

Which intervention should the nurse implement first?