CNM Certified Nurse Midwife

Category - Intrapartum

A client at 38 weeks’ gestation comes to the facility after experiencing leakage of clear fluid from the vagina without contractions. Premature rupture of membranes is suspected. Which of the following actions by the nurse midwife would be inappropriate for a client with this condition?
  1. Perform digital vaginal examination.
  2. Administer ampicillin IV.
  3. Assess the client’s cervix and vaginal cavity through sterile speculum vaginal examination.
  4. Order L/S ratio.
Explanation
Answer: A - Digital vaginal examinations are not performed to avoid the risk of infection. The nurse midwife may assess the client’s cervix and vaginal cavity via sterile speculum vaginal examination. Ampicillin may be administered to prevent infection, a common complication of premature rupture of membranes. An L/S ratio is ordered to assess the maturity of the fetal lung.
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