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 C
Explanation
Choice A rationale
Verifying that the newborn is Rh-negative is not necessary for administering Rh(D) immune globulin. The medication is given to Rh-negative mothers to prevent Rh sensitization, regardless of the newborn’s Rh status.
Choice B rationale
A positive Coombs test indicates that the mother has already been sensitized to Rh-positive blood cells, making Rh(D) immune globulin ineffective in preventing sensitization.
Choice C rationale
Administering Rh(D) immune globulin within 72 hours after birth is crucial to prevent Rh sensitization in future pregnancies. This timing ensures that the mother’s immune system does not produce antibodies against Rh-positive blood cells.
Choice D rationale
Rh(D) immune globulin is typically administered intramuscularly, not into the abdomen. The preferred sites are the deltoid muscle or the anterolateral aspect of the thigh.
Correct Answer is D
Explanation
Choice A rationale
A temperature of 37.8°C (100°F) 18 hours postpartum is slightly elevated but not necessarily indicative of a serious issue. It may require monitoring but is not the most urgent concern.
Choice B rationale
Abdominal pain during breastfeeding 8 hours postpartum is a common experience due to uterine contractions. While it may cause discomfort, it is not typically an urgent concern.
Choice C rationale
Not having a bowel movement 24 hours postpartum is not uncommon and does not usually require immediate attention. It can be addressed with dietary changes and other interventions.
Choice D rationale
Saturating one perineal pad over 2 hours 6 hours postpartum in a G5P4 client indicates a potential risk of postpartum hemorrhage. This is a more urgent concern that requires immediate assessment and intervention to prevent complications.