During a class for women in the second trimester of pregnancy, the nurse discusses methods to alleviate back pain.
Which statement by a class member would indicate the need for additional instruction?

The correct answer is choice B. The administration route of terbutaline will be changed from intravenous to oral.

This is because terbutaline is a medication that can be used to suppress preterm labor by relaxing the uterine smooth muscle.It can be given subcutaneously or intravenously for acute episodes of preterm labor, but it is not recommended for long-term use due to the risk of serious maternal and fetal adverse effects.Therefore, if the client’s condition stabilizes, the administration route of terbutaline will be changed from intravenous to oral, which has a lower bioavailability and less systemic effects.

Choice A is wrong because terbutaline is not usually self-administered parenterally by the client at home.It requires a trained health professional to give it as a shot under the skin or through a vein.

Choice C is wrong because the client does not need to remain in a private room without visitors until she has been without contractions for 48 hours.

This is an unnecessary restriction that may increase the client’s stress and anxiety.

The client should be encouraged to have social support and emotional comfort during this time.

Choice D is wrong because the client should not ambulate in the hallway after 12 hours without contractions.

This may stimulate uterine activity and cause a recurrence of preterm labor.

The client should follow the provider’s instructions on bed rest and activity limitations.

The correct answer is choice B. The patient’s uterine contraction pattern is enhanced.Prostaglandin E2 gel is used to induce labor by ripening and dilating the cervix and stimulating uterine contractions.The effectiveness of the gel can be measured by the frequency, duration and intensity of the contractions.

A stronger and more regular contraction pattern indicates that the gel is working and labor is progressing.

Choice A is wrong because cervical dilation is not the only indicator of labor induction.Cervical dilation can occur without contractions or with weak and irregular contractions, which means that labor is not established yet.

Choice C is wrong because cervical softening (or effacement) is a prerequisite for cervical dilation, but it does not necessarily mean that labor has started.Cervical softening can occur weeks before labor or even during pregnancy.

Choice D is wrong because uterine softening (or relaxation) is the opposite of what prostaglandin E2 gel is supposed to do.Uterine softening reduces the contractility and tone of the uterus, which can lead to prolonged labor or fetal distress.