Question

While giving care to a client who has had premature rupture of membranes, the nurse should refrain from which nursing action?

a) Monitoring vital signs
b) Administering antibiotics
c) Performing a sterile vaginal exam
d) Encouraging fluid intake

Answer 1

In the case of PPROM, a nurse should monitor vital signs, administer antibiotics, and encourage fluid intake, but refrain from performing sterile vaginal exams to avoid infection risks.

Step-by-step explanation:

In the case of a client with preterm premature rupture of membranes (PPROM), certain precautions are necessary to prevent complications such as infection. The nursing actions required include monitoring vital signs and administering antibiotics to minimize infection risk to both the mother and the baby. Additionally, it is recommended to encourage fluid intake which can be beneficial for the mother's hydration and overall well-being. However, the nurse should refrain from performing a sterile vaginal exam unless absolutely necessary, as this can introduce pathogens into the uterine environment and increase the risk of infection.