A nurse is evaluating the fetal heart rate tracing of a client who is in pre-term labor and receiving magnesium sulfate.

The nurse should identify that which of the following patterns indicates a potential adverse effect of the medication on the fetus?

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.

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.