A 34-year-old client who is gravida 1, para 0 has a history of infertility and conceived this pregnancy while taking fertility drugs. She is at 32 weeks' gestation and is carrying triplets. She is complaining of low back pain and a feeling of pelvic pressure. Her cervical exam reveals a long, closed cervix. The nurse notes that the client is experiencing mild uterine contractions every 78 minutes after the nurse has placed her on the fetal monitor. Her condition should indicate that:
- Her cervix shows she will likely deliver soon
- The nurse should not be alarmed because mild uterine activity is common at 32 weeks' gestation
- She may be in preterm labor because this is more common with multiple pregnancies
- She most likely has a urinary tract infection (UTI) because this is common with pregnancy
Answer(s): C
Explanation:
(A) Her cervical exam is normal. There are no cervical changes at this time. (B) Braxton Hicks contractions may be common throughout pregnancy, but they are not regular. (C) Rhythmical contractions in conjunction with low back pain and pelvic pressure at 32 weeks in a woman carrying triplets are of great concern. She may be in preterm labor. (D) UTIs are common in pregnancy due to the enlarging uterus compressing the ureters and the stasis of urine. The woman would be more likely to complain of urinary frequency and urgency, fever or chills, and malodorous urine with a UTI.
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