A nurse is reviewing the medical record of a client who is at 34 weeks of gestation and has pre-term labor.
Which of the following findings is a risk factor for pre-term labor?
History of urinary tract infections
Maternal age of 25 years
Singleton pregnancy
Cervical length of 3 cm
The Correct Answer is A
History of urinary tract infections. According to the Mayo Clinic, untreated vaginal infections, such as urinary tract infections or sexually transmitted infections, are risk factors for preterm labor.
These infections can cause inflammation and irritation of the cervix, which can trigger contractions and cervical dilation.
Choice B is wrong because maternal age of 25 years is not a risk factor for preterm labor. In fact, women younger than 18 or older than 35 are more likely to have a preterm delivery.
Choice C is wrong because singleton pregnancy is not a risk factor for preterm labor. On the contrary, being pregnant with twins, triplets, or more (called "multiple gestations") is associated with a higher risk of preterm labor and birth.
Choice D is wrong because cervical length of 3 cm is not a risk factor for preterm labor. A short cervix (less than 2.5 cm) or a cervix that shortens in the second trimester instead of the third trimester is a risk factor for preterm delivery. A normal cervical length ranges from 3 to 5 cm during pregnancy.
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Correct Answer is A
Explanation
Magnesium sulfate is a tocolytic drug that inhibits uterine activity and relaxes smooth muscles.The goal of magnesium sulfate therapy for a client who is in pre-term labor is to stop or reduce the frequency and intensity of contractions.
Choice B is wrong because the client’s blood pressure decreases to within normal limits.
Magnesium sulfate is not an antihypertensive drug and does not lower blood pressure.It is used to prevent seizures in clients with preeclampsia or eclampsia.
Choice C is wrong because the client’s deep tendon reflexes are 2+.
This is a normal finding and does not indicate the effectiveness of magnesium sulfate therapy.A decrease or loss of deep tendon reflexes may indicate magnesium toxicity, which is a serious complication that requires immediate intervention.
Choice D is wrong because the client’s urine output increases to more than 30 mL/hr.
This is also a normal finding and does not indicate the effectiveness of magnesium sulfate therapy.A decrease in urine output may indicate renal impairment or magnesium toxicity, which are both adverse effects of the drug.
The normal range for serum magnesium level is 1.5 to 2.5 mEq/L or 1.8 to 3 mg/dL.The therapeutic range for magnesium sulfate management is 5 to 8 mg/dL.
Correct Answer is A
Explanation
A white blood cell count of 12,000/mm3 indicates an infection that can trigger pre-term labor.The normal range for white blood cell count in pregnancy is 5.7-15.0×10 9 /L, which is equivalent to 5,700-15,000/mm3.
A count above this range suggests an inflammatory response to an infection.
Choice B is wrong because a hemoglobin level of 11 g/dL is within the normal range for pregnancy, which is 10-14 g/dL.
Choice C is wrong because a platelet count of 250,000/mm3 is within the normal range for pregnancy, which is 150,000-400,000/mm3.
Choice D is wrong because a blood glucose level of 90 mg/dL is within the normal range for pregnancy, which is 70-110 mg/dL.
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