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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?

A.

Magnesium sulfate.

B.

Morphine sulfate.

C.

Terbutaline.

D.

Betamethasone.

Answer and Explanation

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 A

Explanation

Choice A rationale

Assessing for vaginal bleeding in PPROM is generally not necessary unless there is an indication of placental issues or other complications. PPROM involves the rupture of

membranes before 37 weeks, primarily requiring monitoring for infection and fetal wellbeing rather than routine bleeding checks.

Choice B rationale

Monitoring for signs of infection is critical after PPROM because the rupture increases the risk of ascending infections. The nurse should diligently assess for fever, foul-smelling

discharge, and other signs of infection to initiate timely interventions, preserving both maternal and fetal health.

Choice C rationale

Checking for cervical dilation in PPROM is important because premature rupture of membranes can lead to preterm labor. Monitoring dilation helps determine if labor is imminent,

influencing decisions regarding maternal and neonatal care to prevent complications from premature birth.

Choice D rationale

Watching for fetal compromise is necessary following PPROM as premature rupture of membranes can lead to umbilical cord compression or other complications affecting fetal oxygenation. Continuous fetal monitoring helps detect early signs of distress, allowing timely intervention to ensure fetal safety.

Correct Answer is A

Explanation

Choice A rationale

History of preterm birth is the principal risk factor for predicting preterm birth. Previous preterm births significantly increase the likelihood of subsequent preterm deliveries due to

underlying etiological factors.

Choice B rationale

Low prepregnancy weight is a risk factor but not as significant as a history of preterm birth. It can contribute to complications in pregnancy but does not have the same predictive value.

Choice C rationale

Smoking during pregnancy increases the risk of preterm birth but is not the principal risk factor. It is a modifiable behavior that contributes to poor pregnancy outcomes.

Choice D rationale

Obesity can impact pregnancy outcomes but is not the principal risk factor for preterm birth. It is associated with other complications rather than directly predicting preterm delivery.

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