A client at 28 weeks' gestation with intact membranes is admitted with the following findings: contractions every 5 minutes lasting 60 seconds, 3 cm dilated, 80% effaced.
Which of the following medications will the obstetrician likely order?
Magnesium sulfate.
Morphine sulfate.
Terbutaline.
Betamethasone.
The Correct Answer is C
Choice A rationale
Magnesium sulfate is primarily used for neuroprotection in preterm infants and to prevent seizures in severe preeclampsia, not as a first-line tocolytic for preterm labor.
Choice B rationale
Morphine sulfate is an opioid analgesic used for pain management, not for inhibiting preterm labor contractions.
Choice C rationale
Terbutaline is a beta-agonist used as a tocolytic to relax uterine muscles and delay preterm labor. It helps decrease the intensity and frequency of contractions, making it suitable for managing preterm labor.
Choice D rationale
Betamethasone is a corticosteroid used to accelerate fetal lung maturity in preterm labor, not for direct contraction inhibition.
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Correct Answer is B
Explanation
Choice A rationale
Contraction duration less than 40 seconds doesn't define tachysystole. Tachysystole focuses on excessive frequency of contractions rather than their duration.
Choice B rationale
Contraction frequency of more than 5 in 10 minutes defines tachysystole. This condition indicates too frequent uterine activity, which can compromise fetal oxygenation.
Choice C rationale
Contraction intensity less than 80 mm Hg doesn't define tachysystole. Tachysystole is characterized by the number of contractions, not their intensity.
Choice D rationale
Resting tone less than 18 mm Hg is not related to the definition of tachysystole. Tachysystole concerns contraction frequency, not the resting tone of the uterus between contractions. .
Correct Answer is B
Explanation
Choice A rationale
Retained tissue can cause postpartum hemorrhage, but with a firm uterus and no other signs of retained placenta, this is less likely the cause here.
Choice B rationale
Trauma is the most likely cause of increased bleeding in this scenario. The prolonged oxytocin induction and macrosomic infant suggest a higher risk of lacerations or uterine atony
despite the firm uterus.
Choice C rationale
Thrombin disorders cause bleeding due to clotting issues. However, this patient shows signs of active bleeding and clotting, making this less likely.
Choice D rationale
Uterine atony, indicated by a soft, boggy uterus, is a common cause of postpartum hemorrhage, but in this case, the uterus is firm, so it's less likely to be the cause.