Question

The nurse is reviewing the health care provider's (HCP's) prescriptions for a client admitted for premature rupture of the membranes. Gestational age of the fetus is determined to be 37 weeks. Which prescription should the nurse question?

A. Administering corticosteroids for fetal lung maturity
B. Administering tocolytic medication
C. Administering antibiotics
D. Initiating oxytocin infusion

Answer 1

The nurse should question the prescription for administering corticosteroids for fetal lung maturity in a client with PROM at 37 weeks because lung development is generally adequate at this gestational age. Antibiotics and oxytocin could be appropriate depending on the clinical situation.

Step-by-step explanation:

A client admitted for premature rupture of membranes (PROM) at a gestational age of 37 weeks would generally not require the administration of corticosteroids for fetal lung maturity, as this is indicated for promoting fetal lung development in pregnancies less than 34 weeks gestation, where the risk of respiratory distress syndrome (RDS) is significant. By 37 weeks, the fetus is considered to be of early term and the lungs are typically sufficiently matured. Therefore, the nurse should question the prescription for administering corticosteroids.

On the other hand, antibiotics may be prescribed as prophylaxis to prevent infection due to the uterine environment being compromised by the ruptured membranes. Tocolytic medication might be administered to delay labor and delivery if needed for completion of antenatal corticosteroids or transfer; though at 37 weeks, its necessity would be based on the specific clinical situation. An oxytocin infusion might be initiated to induce or augment labor, particularly if there's a concern about infection and the baby needs to be delivered.