A woman at 30 weeks' gestation is 80% effaced and 5 cm dilated. Which action by the nurse takes priority?
A.
Arrange a palliative care consult for probable fetal demise.
B.
Encourage the woman to attempt a trial of labor before undergoing a cesarean section.
C.
Ensure that informed consent for a cesarean birth is on the chart.
D.
Inform the woman that if the tocolytic therapy is successful, she will deliver.
ANS: C
In preterm labor, if the woman's membranes have ruptured or if her cervix is more than 50% effaced and 3-4 cm dilated, it is not likely that the labor can be stopped. A cesarean birth is preferable to a vaginal delivery because it diminishes pressure on the fetal head and decreases the risk of intracranial hemorrhage. Because there is a high likelihood of cesarean birth, the nurse should ensure that consent for cesarean delivery is on the chart, in the event that the labor cannot be halted. Tocolytic medications are administered to halt contractions; if unsuccessful, the birth will occur.
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