The perinatal nurse is assessing a woman who is at 35 weeks' gestation in her first pregnancy. She is worried about having her baby "too soon," and she is experiencing uterine contractions every 10 to 15 minutes. The fetal heart rate is 136 beats/minute. A vaginal examination performed by the health-care provider reveals no cervical changes since her last examination. Ultrasound examination reveals the presence of V-shaped cervical funneling. Which action by the nurse is most appropriate? A. Educate the woman on benefits of corticosteroids. B. Facilitate admission to the high-risk OB unit. C. Prepare to administer a dose of magnesium sulfate. D. Reassure the woman that she is not in preterm labor. - ANS: D Preterm labor is defined as regular uterine contractions and cervical changes before the end of the 37th week of gestation. Many patients present with preterm contractions but only those who demonstrate changes in the cervix are diagnosed with preterm labor. Because this woman has no demonstrated cervical changes, she does not have the diagnosis. Also reassuring is the infrequency of her contractions; a defining characteristic of preterm labor is persistent uterine contractions (4 every 20 minutes or 8 per hour). Another reassuring finding is the presence of V-shaped cervical funneling ; a change to U-shaped cervical funneling in a woman with a shortened cervix is associated with preterm labor in high-risk women with a prior spontaneous preterm birth. The woman does not require corticosteroids or magnesium sulfate or admission to the highrisk OB unit.
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