A nurse is evaluating a client who is at 28 weeks of gestation and has pre-term labor.
Which of the following findings indicates that the client’s condition is improving?
Decreased frequency and intensity of contractions
Increased cervical dilation and effacement
Increased amount and color of vaginal discharge
Decreased fetal heart rate variability
The Correct Answer is A
Decreased frequency and intensity of contractions indicates that the client’s condition is improving. Preterm labor occurs when regular contractions result in the opening of your cervix before 37 weeks of pregnancy.
If preterm labor can’t be stopped, your baby will be born early and may have health problems.
Choice B is wrong because increased cervical dilation and effacement means that the cervix is thinning and opening more, which are signs of labor progression.
Choice C is wrong because increased amount and color of vaginal discharge may indicate infection, bleeding, or rupture of membranes, which are complications of preterm labor.
Choice D is wrong because decreased fetal heart rate variability means that the baby’s heart rate is not changing much, which may indicate fetal distress or hypoxia. A normal fetal heart rate variability is between 6 and 25 beats per minute.
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Correct Answer is A
Explanation
Betamethasone is a corticosteroid that is given to pregnant women who are at risk of preterm labor to improve neonatal outcomes.Betamethasone stimulates the production of surfactant, a substance that lubricates the lungs and prevents them from collapsing after birth.This reduces the risk of respiratory distress syndrome, a common complication of preterm birth.
Choice B is wrong because betamethasone does not decrease the risk of infection in the newborn.In fact, it may increase the risk of maternal and neonatal infections by suppressing the immune system.
Choice C is wrong because betamethasone does not increase blood glucose levels in the newborn.However, it may cause transient hyperglycemia in the mother, which should be monitored and treated if necessary.
Choice D is wrong because betamethasone does not decrease the risk of bleeding in the newborn.It may increase the risk of intraventricular hemorrhage, a type of bleeding in the brain, if given before 24 weeks of gestation.Therefore, it should be used with caution in this population and only after a family’s decision regarding resuscitation.
Correct Answer is B
Explanation
A cervical cerclage is a procedure that involves placing stitches around the cervix to prevent it from opening prematurely.This procedure is usually done for women who have a history of cervical insufficiency or a short cervix, which are risk factors for preterm labor.
Choice A is wrong because history of gestational diabetes is not a risk factor for preterm labor.
Gestational diabetes is a condition that causes high blood sugar during pregnancy and can affect the health of the mother and the baby, but it does not increase the risk of preterm labor.
Choice C is wrong because history of recurrent urinary tract infections (UTIs) is a risk factor for preterm labor.
UTIs are infections that affect the urinary system and can cause symptoms such as pain, burning, or frequent urination.
UTIs can also spread to the kidneys or the uterus and cause inflammation or infection that can trigger preterm labor.
Choice D is wrong because history of assisted reproductive technology (ART) is a risk factor for preterm labor.
ART refers to any medical procedure that helps with conception, such as in vitro fertilization (IVF).
ART can increase the risk of preterm labor because it can result in multiple gestations (twins, triplets, or more), which put more strain on the uterus and can cause it to contract prematurely.ART can also cause complications such as placenta previa or rupture of the uterus, which can lead to preterm labor.
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