A nurse is reinforcing teaching about preterm labor with a client who is at 28 weeks of gestation.Which of the following statements by the client indicates an understanding of the teaching?
“I should expect to feel pain in my upper right abdomen if I’m having preterm labor.”.
“If I have contractions more often than every 10 minutes, I might be in preterm labor.”.
“I can take a daily iron supplement to prevent preterm labor.”.
“I might be experiencing preterm labor if walking stops my contractions.”.
The Correct Answer is B
Choice A rationale
Pain in the upper right abdomen is not a typical sign of preterm labor. Preterm labor symptoms include regular contractions, lower back pain, and pelvic pressure.
Choice B rationale
Contractions occurring more frequently than every 10 minutes can indicate preterm labor. Regular contractions are a key sign of preterm labor.
Choice C rationale
While iron supplements are important during pregnancy, they do not prevent preterm labor. Preterm labor is influenced by various factors, including infections and uterine abnormalities.
Choice D rationale
Walking typically does not stop contractions associated with preterm labor. In fact, activity can sometimes exacerbate contractions.
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Correct Answer is D
Explanation
Choice A rationale
Diuresis, or increased urine production, is not a common adverse effect of nalbuphine hydrochloride. This medication is an opioid analgesic used for pain relief during labor.
Choice B rationale
Fever is not a typical adverse effect of nalbuphine hydrochloride. Fever may indicate an infection or other underlying condition that needs to be addressed separately.
Choice C rationale
Diarrhea is not a common adverse effect of nalbuphine hydrochloride. Opioids, including nalbuphine, are more likely to cause constipation rather than diarrhea.
Choice D rationale
Sedation is a known adverse effect of nalbuphine hydrochloride. As an opioid analgesic, it can cause drowsiness and sedation, which is important to monitor in laboring clients to ensure their safety and well-being.
Correct Answer is A
Explanation
Choice A rationale
An intrauterine device (IUD) is contraindicated for a client who has a positive pregnancy test. Inserting an IUD during pregnancy can lead to complications such as infection, miscarriage, and preterm birth. It is crucial to confirm the absence of pregnancy before IUD insertion.
Choice B rationale
A history of gallbladder disease does not contraindicate the use of an IUD. IUDs are primarily contraindicated in cases of active pelvic infection, certain uterine abnormalities, and confirmed pregnancy, but not gallbladder disease.
Choice C rationale
While smoking is a significant risk factor for many health issues, including cardiovascular disease, it is not a direct contraindication for the use of an IUD. However, smokers should be counseled about the risks of smoking and offered support to quit.
Choice D rationale
Being nulliparous (having never given birth) is not a contraindication for IUD use. IUDs can be safely used by nulliparous women, though some might have a slightly higher risk of expulsion or insertion-related discomfort compared to women who have given birth.