A woman at 32 weeks' gestation is admitted to the high-risk OB unit with a diagnosis of preterm labor. On assessment the nurse finds the following:
blood pressure, 182/96 mm Hg; pulse, 106 beats/minute; respirations, 16 breaths/minute; regular uterine contractions of 5 in 10 minutes; and fetal heart rate of 145 beats/minute. She is dilated to 8 cm. Which action by the nurse is best?
A.
Administer the ordered dose of betamethasone (Celestone).
B.
Call for an immediate electrocardiogram (EKG).
C.
Document the findings and prepare for emergent delivery.
D.
Prepare to administer magnesium sulfate (Sulfamag).
ANS: A
The administration of antenatal corticosteroids (betamethasone) is the most beneficial intervention for improvement of neonatal outcomes among women who give birth preterm. A single course of corticosteroids is recommended for pregnant women between 24 and 34 weeks of gestation who are at risk of preterm delivery within 7 days. Although the woman is mildly tachycardic, there is no need for an EKG without further information. There is no indication that delivery is imminent. Magnesium sulfate is a tocolytic drug used to stop labor, but it is contraindicated in women with advanced cervical dilation.
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