A nurse is performing a digital examination on a client who is at 34 weeks of gestation and has pre-term labor.

Which of the following findings indicates cervical effacement?

White blood cell count 25,000/mm3.

This indicates a potential complication of necrotizing enterocolitis (NEC), which is the death of intestinal tissue in premature or sick newborns.A high white blood cell count can be a sign of infection or inflammation in the bowel, which are common features of NEC.

Choice A is wrong because hematocrit 45% is within the normal range for newborns.

Hematocrit measures the percentage of red blood cells in the blood.

A low hematocrit can indicate blood loss or anemia, which can be complications of NEC, but a normal hematocrit does not rule out NEC.

Choice B is wrong because platelets 150,000/mm3 is also within the normal range for newborns.

Platelets are cells that help the blood clot.A low platelet count can indicate a consumption coagulopathy, which is a bleeding disorder that can occur in severe cases of NEC.

However, a normal platelet count does not exclude NEC.

Choice D is wrong because blood glucose 80 mg/dL is also within the normal range for newborns.

Blood glucose measures the amount of sugar in the blood.

A low blood glucose can indicate hypoglycemia, which can be caused by sepsis or other conditions that mimic NEC, but a normal blood glucose does not eliminate NEC.

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.