What intervention should be prioritized for a pregnant client with spontaneous rupture of membranes before labor?

In the situation of a pregnant client with spontaneous rupture of membranes, the priority intervention is to keep vaginal exams to a minimum. This is important because excessive vaginal examinations can introduce bacteria into the uterus, increasing the risk of infection for both the mother and the fetus. Once the membranes have ruptured, the barrier that protects the amniotic fluid from the outside environment is compromised, making the fetus more vulnerable to infections such as chorioamnionitis.

Keeping vaginal exams limited helps to reduce this risk and maintain the integrity of the sterile environment necessary during labor and delivery. Monitoring and assessing the situation can still be performed through other means, such as observing for signs of labor progression or fetal well-being, without needing frequent internal examinations.

While the other interventions may support the client’s overall experience and comfort, they do not directly address the immediate risks associated with ruptured membranes. Encouraging ambulation could be suitable in some circumstances, but it may not be advisable if there are concerns about infection or if the client is unstable. Increasing fluid intake is also beneficial, but it is not the primary focus in the context of potential infection risk. Providing emotional support is essential for the client’s mental well-being during labor but does not physically address the critical concern of preventing infection