Assessment
Assessment ( 15 Questions)
A nurse is assessing a client for pre-term labor.
Which of the following assessments should the nurse prioritize?
Obtaining a detailed history of previous pregnancies is not a priority assessment for pre-term labor.
While it can provide some information about the client’s risk factors, it does not indicate the current status of the pregnancy or the cervix.
Checking the fetal heart rate and activity is not a priority assessment for pre-term labor.
While it can provide some information about the fetal well-being, it does not indicate the presence or absence of contractions or cervical changes.
This is because a speculum examination can help determine the presence of cervical dilation, effacement, or infection, which are signs of pre-term labor.
A speculum examination can also detect the presence of fetal fibronectin, which is a protein that indicates an increased risk of pre-term delivery.
Performing laboratory tests, such as urine culture, is not a priority assessment for pre-term labor.
While it can help identify possible infections that may contribute to pre-term labor, it does not provide immediate results or indicate the current status of the cervix.
Performing a speculum examination of the vagina and cervix.
This is because a speculum examination can help determine the presence of cervical dilation, effacement, or infection, which are signs of pre-term labor.
A speculum examination can also detect the presence of fetal fibronectin, which is a protein that indicates an increased risk of pre-term delivery.
Choice A is wrong because obtaining a detailed history of previous pregnancies is not a priority assessment for pre-term labor.
While it can provide some information about the client’s risk factors, it does not indicate the current status of the pregnancy or the cervix.
Choice B is wrong because checking the fetal heart rate and activity is not a priority assessment for pre-term labor.
While it can provide some information about the fetal well-being, it does not indicate the presence or absence of contractions or cervical changes.
Choice D is wrong because performing laboratory tests, such as urine culture, is not a priority assessment for pre-term labor.
While it can help identify possible infections that may contribute to pre-term labor, it does not provide immediate results or indicate the current status of the cervix.