RN Nursing · High-Risk Pregnancy — Preterm Labor · Practice question
Click to highlight the findings that require immediate follow-up. To deselect a finding, click on the finding again.
Client at 34 weeks of gestation — amniocentesis
Diagnostic Results
B. Lecithin/sphingomyelin (L/S) ratio 1.4:1 (greater than 2:1) C. Phosphatidylglycerol (PG) negative (positive) D. ABO-Rh B-negativeMedication Administration Record
A. Terbutaline 0.25 mg SQ every hr PRN contractions B. Rh(D) immune globulin 300 mcg IM once C. Nalbuphine 10 mg IV every 3 hr PRN painProgress Report
1655: Amniocentesis completed, tocotransducer and external fetal monitor applied. 1700: A. Fetal heart rate 130/min with moderate variability. B. Uterine contractions occurring every 5 to 8 min lasting 30 to 60 seconds duration. C. Uterine contractions palpated as mild intensity. D. Client reports uterine contraction pain of 2 on a scale of 0 to 10.Answer & explanation
Correct:
This client at 31 weeks gestation presents with classic preterm labor with a likely UTI/pyelonephritis trigger. Findings requiring immediate follow-up: (1) Temperature 38.3°C (101°F) — fever suggests urinary tract infection, a common cause of preterm labor. (2) Client's report of cramping, low back pain, and burning on urination — symptoms of both preterm labor and UTI. (3) Uterine contractions every 2 minutes lasting 40–60 seconds with mild-to-moderate intensity — frequent contractions before 37 weeks confirm preterm labor. (4) Cervix 2 cm dilated and 80% effaced — confirms cervical change consistent with active preterm labor, requiring tocolysis, betamethasone, antibiotics, and possible transfer to higher-level care. FHR is reassuring; other vital signs are normal.
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