A nurse is preparing to perform an amniocentesis on a client who is at 27 weeks of gestation and has pre-term labor.

Which of the following actions should the nurse take before the procedure?

Administer tocolytic medication to stop contractions

Instruct the client to empty her bladder

Obtain informed consent from the client

Monitor fetal heart rate and activity

Answer and Explanation

The Correct Answer is B

Instruct the client to empty her bladder. This is because a full bladder can interfere with the insertion of the needle and increase the risk of injury to the bladder or the uterus. Emptying the bladder also reduces discomfort during the procedure.

Choice A is wrong because administering tocolytic medication to stop contractions is not necessary before amniocentesis. Tocolytic medication can have side effects and should only be used when there is a clear indication of preterm labor.

Choice C is wrong because obtaining informed consent from the client is not a nursing action, but a medical one. The nurse can assist in providing information and answering questions, but the final consent should be obtained by the doctor who will perform the procedure.

Choice D is wrong because monitoring fetal heart rate and activity is not a specific action before amniocentesis, but a routine part of prenatal care. Fetal heart rate and activity can be affected by many factors, such as maternal position, fetal sleep cycle, or maternal blood sugar level.

Monitoring them before amniocentesis does not provide any useful information for the procedure.

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Correct Answer is B

Explanation

Cervix is shortened and thinned.This indicates cervical effacement, which is the thinning and softening of the cervix in preparation for childbirth.Cervical effacement is measured in percentages, from 0% (no effacement) to 100% (fully effaced).

Choice A is wrong because cervix is soft and pliable does not necessarily mean it is effaced.The cervix can soften before it thins and shortens.

Choice C is wrong because cervix is dilated and open indicates cervical dilation, which is the opening of the cervix.Cervical dilation is measured in centimeters, from 0 cm (closed) to 10 cm (fully dilated).

Cervical dilation and effacement are related, but not the same.

Choice D is wrong because cervix is posterior and high indicates the position of the cervix in relation to the vagina.The cervix can move from posterior (back) to anterior (front) and from high to low as labor progresses.

The position of the cervix does not indicate effacement.

A. Infection on speculum examination B. Bleeding on speculum examination C. Positive fetal fibronectin test (FFN) D. Normal fetal heart rate and activity

Correct Answer is A

Explanation

Infection on speculum examination.

Infection is a major cause of preterm labor and can lead to serious complications for the mother and the fetus.

Infection can be detected by a speculum examination that shows signs of inflammation, such as erythema, edema, discharge, or odor.

Infection can also be confirmed by laboratory tests, such as culture, gram stain, or polymerase chain reaction.Infection should be treated promptly with antibiotics and other supportive measures.

Choice B. Bleeding on speculum examination is wrong because bleeding is not a direct cause of preterm labor, but rather a sign of other conditions that may increase the risk of preterm labor, such as placenta previa, placental abruption, or cervical trauma.Bleeding should be evaluated further to determine the source and severity of the hemorrhage and to manage any complications.

Choice C. Positive fetal fibronectin test (FFN) is wrong because a positive FFN test indicates the presence of fetal fibronectin in the cervical or vaginal secretions, which is a marker of increased risk of preterm labor, but not a definitive marker.

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A nurse is preparing to perform an amniocentesis on a client who is at 27 weeks of gestation and has pre-term labor. Which of the following actions should the nurse take before the procedure?

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A nurse is preparing to perform an amniocentesis on a client who is at 27 weeks of gestation and has pre-term labor.

Which of the following actions should the nurse take before the procedure?