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A preterm labor client at 30 weeks' gestation reported rupture of membranes 4 hours ago. This was confirmed on examination. The nurse prepares to administer IM dexamethasone. When the client asks why she is receiving the drug, the nurse replies:

A.

To help stop your labor contractions.

B.

To prevent an infection in your uterus.

C.

To help mature your baby's lungs.

D.

To decrease the pain from the contractions.

E.

To decrease the pain from the contractions.

Answer and Explanation

The Correct Answer is C

Choice A rationale

Dexamethasone does not directly stop labor contractions; instead, it is used to enhance fetal lung maturity.

 

Choice B rationale

Dexamethasone is not for infection prevention; antibiotics are used for that purpose in cases of premature rupture of membranes.

 

Choice C rationale

Dexamethasone is administered to enhance fetal lung maturity, reducing the risk of respiratory distress syndrome in preterm infants.

 

Choice D rationale

Dexamethasone is not used for pain relief in preterm labor; other medications are prescribed for pain management.


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Correct Answer is D

Explanation

Choice A rationale

Placental abruption involves the detachment of the placenta from the uterine wall before delivery, causing bleeding, abdominal pain, and uterine tenderness. It does not typically cause dyspnea, hypotension, frothy sputum, or loss of consciousness.

Choice B rationale

Uterine rupture is a tear in the uterine wall, often in a scarred uterus. Symptoms include severe abdominal pain, abnormal fetal heart rate, and vaginal bleeding. It can cause shock, but not frothy sputum or sudden dyspnea.

Choice C rationale

Uterine inversion occurs when the uterus turns inside out, often during placental delivery. It leads to pain, hemorrhage, and shock. Like uterine rupture, it does not cause frothy sputum or sudden dyspnea.

Choice D rationale

Anaphylactoid syndrome (amniotic fluid embolism) occurs when amniotic fluid enters the maternal circulation, causing an anaphylactic reaction. Symptoms include sudden dyspnea, hypotension, frothy sputum, and loss of consciousness, fitting the scenario described.

Correct Answer is A

Explanation

Choice A rationale

Methylergonovine (Methergine) is used to manage postpartum hemorrhage by stimulating uterine contractions. It is especially useful in cases like this where rapid uterine tone is needed.

Choice B rationale

Magnesium sulfate is used to prevent seizures in preeclamptic patients, not to manage postpartum hemorrhage. This choice is incorrect in this context.

Choice C rationale

Carboprost-tromethamine (Hemabate) is also used for treating postpartum hemorrhage but is typically a secondary option to methylergonovine and may have more side effects.

Choice D rationale

Fresh frozen plasma (FFP) is used to replace clotting factors in cases of coagulopathy, not as a primary intervention for postpartum hemorrhage in this patient.

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