Which of the following pieces of information that the nurse obtains from a pregnant client would indicate this client is at risk for preterm labor?
1. The client smokes two packs of cigarettes per day and delivered her last child at 34 weeks.
2. The client has group B streptococcus in her urine, and is primiparous.
3. The client had congenital hip dysplasia as a child and is 15 pounds overweight.
4. The client lives in a second-floor apartment without stairs, and walks to work.
1
Rationale:
1. Smoking is a risk factor for preterm birth and low birth weight. Nicotine is a vasoconstrictor, and causes the arterioles in the placenta and the uterus to constrict, decreasing blood flow to the uterine musculature as well as the fetus. During and after smoking a cigarette, both the maternal and fetal oxygen saturation drop, and the carbon monoxide found in cigarette smoke also will decrease fetal oxygenation.
2. The presence of group B streptococcus puts the newborn at risk for sepsis after delivery.
3. Neither hip dysplasia nor being 15 pounds overweight predisposes a woman to developing preterm labor.
4. Walking is considered moderate-intensity exercise, and is a healthy practice during pregnancy.
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