CH 10 Flashcards
Chorioamnionitis
Infection of the amniotic sac
What are subjective assessment findings of a woman In preterm labor
Persistent low backache Pressure in the pelvis and cramping GI cramping, sometimes with diarrhea Urinary frequency Vaginal discharge
What are objective physical assessment findings of a woman In preterm labor
Increase change or blood in vaginal discharge
Change in cervical dilation
Regular uterine contractions with a frequency of q10 min or greater lasting 1 hour or longer
PROM
What are lab tests to determine if a woman is in preterm labor
Fetal fibronectin
Cervical cultures
CBC
urinalysis
When should a swab of vaginal secretions for fetal fibronectin be done
Between 24-34 weeks gestation. This protein can be found in the vaginal secretions when fetal membrane integrity is lost
What is preterm labor defined as
It is defined as uterine contractions and cervical changes that occur between 20 and 37 weeks gestation
What tests provide information about a fetus’ well being
BPP and no stress test
What are nursing interventions for a client in preterm labor
FOCUSING ON STOPPING UTERINE CONTRACTIONS!!!!!!!!!
Activity restriction/ resting in the left lateral position increases blood flow to the uterus and decrease uterine activity/ avoid sex
Ensuring hydration/ preventing dehydration prevents the release of oxytocin, which stimulates uterine contractions.
Identify and treat infection
Monitor FHR and contraction pattern
Administer meds/ nifedipine ( procardia) , magnesium sulfate, indomethacin, or betamethasone.
When should chorioamniotitis suspected
With the occurrence of elevated temp, and tachycardia
What are nursing considerations for administering calcium channel blockers to a woman in preterm labor
Monitor for headache, flushing, dizziness, and nausea. They are usually r/t orthostatic hypotension that occurs with administration.
Do not administer concurrently with magnesium sulfate.
It is used to suppress contractions by inhibiting calcium from entering smooth muscles.
What is magnesium sulfate used for
It,is a commonly used tocolytic that relaxes the smooth muscle of the uterus and thus inhibits uterine activity by suppressing contractions
When should tocolytic therapy be discontinued
Magnesium sulfate therapy should be discontinued if the c,isn’t exhibits manifestations of PE, which includes chest pain, SOB, RESPIRATORY DISTRESS, audible wheezes and crackles, and or a productive cough containing blood tinged sputum.
What is indomethacin used for
It is a NSAID that suppresses preterm labor by blocking the production of prostaglandins. This inhibition of prostaglandins suppresses uterine contractions
How long should indomethacin treatment be prescribed
It should not exceed 48 hr. It should only be used if gestational age is less than 32 weeks
When should betamethasone be administered
It should be administered into the gluteal muscle 24-48 hr prior to birth