A nurse is caring for a 32-year-old female client who is at 36 weeks of gestation in the labor and delivery unit. Exhibits The nurse should monitor the client’s dropdown due to the risk of dropdown.

The nurse should monitor the client’s temperature due to the risk of chorioamnionitis. Rationale for correct answers Temperature monitoring is crucial for detecting chorioamnionitis, an infection of the amniotic sac, which is a major risk following preterm premature rupture of membranes (PPROM). PPROM increases susceptibility to ascending bacterial infection, leading to inflammation. Fever (>38°C or 100.4°F) is a primary diagnostic criterion. Chorioamnionitis presents with maternal fever, fetal tachycardia (>160/min), uterine tenderness, and foul-smelling amniotic fluid. The client's normal temperature now (36.7°C) requires ongoing monitoring, as infection could develop rapidly. Rationale for incorrect Response 1 options Magnesium levels: Magnesium sulfate is used for seizure prophylaxis in eclampsia or for neuroprotection in preterm labor. This client has no signs of either condition. Fundal height: Measurement assesses fetal growth and amniotic fluid levels; it is not a direct indicator of infection risk. Clotting factors: No evidence of coagulopathy or bleeding abnormalities; coagulation profile is normal. Rationale for incorrect Response 2 options Concealed hemorrhage: No signs of placental abruption (painful bleeding, rigid abdomen). Normal hemoglobin (12.0 g/dL) supports this. Seizures: No hypertensive crisis or neurological symptoms suggestive of eclampsia. Disseminated intravascular coagulation (DIC): No abnormal coagulation markers or evidence of excessive bleeding. Take-home points • PPROM increases the risk of chorioamnionitis, a serious intrauterine infection. • Fever monitoring is essential, as maternal fever is an early indicator of infection. • Antibiotics are given prophylactically to reduce chorioamnionitis risk in PPROM. • Differentiation from placental abruption, eclampsia, and DIC is based on clinical and laboratory findings.