A client at 30 weeks' gestation complains of shortness of breath and an unusually rapid enlargement of the uterus. A tense uterus is noted by the nurse midwife during assessment. Palpation of the small parts of the fetus and auscultating the fetal heart rate are difficult. The nurse midwife suspects severe hydramnios. Which of the following interventions are appropriately included in the care plan?
I. Encourage ambulation
II. Increase intake of foods high in fiber
III. Perform amniocentesis
IV. Administer indomethacin

Question

Quizplus · Accepted Answer

The nurse midwife may increase the client's intake of foods high in fiber, perform amniocentesis and administer indomethacin. Hydramnios may cause fetal malpresentation, premature rupture of the membranes and pre-term labor. The client should increase her fiber intake to prevent constipation because straining to defecate could increase the uterine pressure and cause rupture of the membranes. Amniocentesis may be performed to remove some of the excess amniotic fluid, but this intervention is a temporary measure, as amniotic fluid is replaced rapidly. Indomethacin may reduce the total volume.

A Client at 30 Weeks' Gestation Complains of Shortness of Breath