A nurse is caring for a client at 30 weeks gestation who is admitted for preterm labor. Which of the following interventions should the nurse anticipate? Select all that apply.

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Preterm labor (PTL) is defined as progressive cervical dilation and/or effacement resulting from uterine contractions before term gestation. The nurse should anticipate the following interventions for clients in PTL before 34 weeks gestation: Administering IM antenatal glucocorticoids (eg, betamethasone, dexamethasone) to stimulate fetal lung maturation and promote surfactant development (Option A) Administering antibiotics (eg, penicillin) to prevent group B Streptococcus infection in the newborn if preterm birth occurs (Option B) Initiating an IV magnesium sulfate infusion for fetal neuroprotection if at <32 weeks gestation (Option D) Giving tocolytic medications (eg, nifedipine, indomethacin) to suppress uterine activity, which allows antenatal glucocorticoids time to have a therapeutic effect Monitoring pertinent laboratory results, including cultures for vaginal or urinary tract infection and group B Streptococcus, if obtained (Option C) Artificial rupture of membranes (AROM), or amniotomy, is performed to augment labor or assess amniotic fluid in clients who are at term gestation. For clients in PTL, the goal is to prolong pregnancy if possible. Therefore, AROM is contraindicated. (Option E) Clients with suspected PTL should be placed on continuous fetal monitoring to assess for increasing frequency and duration of contractions and to evaluate fetal tolerance of labor. Continuous fetal monitoring is also required if the client is receiving a magnesium sulfate infusion. Educational objective: Preterm labor is progressive cervical dilation and/or effacement resulting from uterine contractions before term gestation. The nurse should anticipate several interventions, including administration of IM antenatal glucocorticoids, antibiotics, and IV magnesium sulfate.

A Nurse Is Caring for a Client at 30 Weeks