A nurse is performing a physical examination on a client who is at 30 weeks of gestation and has pre-term labor.

Which of the following findings indicates fetal distress?

A positive fetal fibronectin test (FFN) indicates that the fetal membrane has been disrupted and labor may occur within the next 7 to 14 days.

This is a sign of preterm labor that should be reported immediately.

Choice A is wrong because elevated blood glucose level is not a sign of preterm labor, but a possible complication of gestational diabetes.

Choice B is wrong because thinning of the cervix (also called effacement) is a normal process that occurs during late pregnancy and labor.

It does not necessarily indicate preterm labor.

Choice D is wrong because abdominal tenderness is not a specific sign of preterm labor.

It could be caused by other factors such as constipation, gas, or stretching of the ligaments.

Some of the signs and symptoms of preterm labor include:

• Regular or frequent sensations of abdominal tightening (contractions) every 10 minutes or more often

• Change in vaginal discharge (leaking fluid or bleeding from the vagina)

• Feeling of pressure in the pelvis (hip) area

• Low, dull backache

• Cramps that feel like menstrual cramps

• Abdominal cramps with or without diarrhea

Maintaining a neutral head position.This action can help reduce the client’s risk of intraventricular hemorrhage (IVH) by preventing fluctuations in intracranial pressure that could rupture blood vessels in the brain.

Choice A is wrong because encouraging early ambulation can increase the risk of IVH by causing changes in blood pressure and cerebral perfusion.

Choice B is wrong because administering medications to induce hypercoagulability can increase the risk of IVH by promoting thrombosis and impairing blood flow to the brain.

Choice C is wrong because monitoring the client’s blood glucose levels is not directly related to the prevention of IVH, although it may be important for other reasons such as avoiding hypoglycemia or hyperglycemia.