Chapter 32 Flashcards

1
Q

Preterm Birth

A

Any birth that occurs between 20-37 weeks gestation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Risk factors for spontaneous preterm labor

A

hx of spontaneous preterm labor, not white, genital tract infection, multifetal gestation, second trimester bleeding, low prepregnancy weight.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what is the only factor show to be definitely associated with preterm labor?

A

infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

common causes of indicated preterm labor

A

gestational diabetes, chronic HTN, preeclampsia, previous cesarean birth, seizures, thromboembolism, advanced maternal age, HIV or herpes, obesity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

women whose cervical length is greater than ______ are unlikely to have preterm birth.

A

30 mm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Fetal fibronectin (fFN)

A

Diagnostic test for preterm labor; collect fluid from the woman’s vagina using a swab; the presence of fFN during the late second and early third trimesters may be indicative of preterm labor coming

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Signs and Symptoms of Preterm Labor

A

contractions occurring more than q 10 min for 1 hour or more, lower abdominal cramping, dull lower back pain, suprapubic pain or pressure, urinary frequency, change in character or amount of usual discharge, rupture of amniotic membranes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Teaching for Preterm Labor

A

Empty your bladder. Drink 2-3 glasses of water or juice. Lie down on your side for 1 hour. Palpate for contractions. If sx continue, call pcp or go to hospital. If sx go away then resume light activity.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Tocolytics

A

meds given to stop labor after uterine contractions and cervical change has already occurred.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Maternal contraindications to tocolysis

A

preeclampsia w/ severe features, bleeding, contraindications to specific tocolytic meds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Fetal contraindications to tocolysis

A

intrauterine fetal demise, lethal fetal anomaly, nonreassuring fetal status, chorioamnionitis, PROM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Magnesium Sulfate Safety Alert

A

frequently assess respiratory status, DTR’s, and LOC to monitor for toxic levels; depresses the CNS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Don’t give Nifedipine with

A

Magnesium sulfate or Terbutaline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Nifedipine (Calcium Channel Blocker) Safety Alert

A

Change positions slowly!!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Magnesium Sulfate Antidote

A

Calcium gluconate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

When should Indomethacin be given

A

at less than 32 weeks gestation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Indomethacin

A

monitor for hemorrhage or signs of bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Terbutaline

A

monitor blood glucose and potassium levels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Magnesium sulfate therapeutic range

A

4-7.5 mEq/L

20
Q

Antenatal glucocorticoids

A

given IM to accelerate fetal lung maturity by stimulating fetal surfactant production

21
Q

Antenatal glucocorticoids should be given when

A

between 24-34 weeks gestation

22
Q

Where to give antenatal glucocorticoids

A

deep IM: vastus lateralis or ventral gluteal

23
Q

The most important function of tocolytics

A

to give time to administer antenatal glucocorticoids and get them working to accelerate fetal lung maturity

24
Q

Risk factors for preterm PROM

A

hx of cervical cerclage, UTI, short cervical length, uterine overdistention, preterm labor, second and third trimester bleeding, low BMI, pulmonary disease, low socioeconomic status, cigarette smoking, nutritional deficiencies

25
Q

The most common maternal complication of preterm PROM

A

Chorioamnionitis

26
Q

Chorioamnionitis

A

bacterial infection of the amniotic cavity

27
Q

postterm pregnancy

A

42 or more weeks gestation

28
Q

teaching for postterm pregnancy

A

perform daily fetal movement counts (4 an hour). assess for sx of labor. call pcp if membranes rupture or there is a decrease in or no fetal movement. keep appointments

29
Q

Dysfunctional Labor (dystocia)

A

a long, difficult or abnormal labor

30
Q

Hypertonic uterine dysfunction

A

frequent and painful contractions that are ineffective in causing cervical dilation or effacement to progress

31
Q

Hypotonic uterine dysfunction

A

most common type; woman initially makes progress into active phase of labor but then contractions become weak and inefficient or stop altogether.

32
Q

prolonged latent phase in the nulliparas woman

A

more than 20 hours

33
Q

prolonged latent phase in the multiparas woman

A

more than 14 hours

34
Q

protracted active phase dilation in the nulliparas woman

A

less than 1.2 cm in an hour

35
Q

protracted active phase dilation in the multiparas woman

A

less than 1.5 cm in an hour

36
Q

protracted descent in the nulliparas woman

A

less than 1 cm in an hour

37
Q

protracted descent in the multiparas woman

A

less than 2 cm in an hour

38
Q

arrest of descent in the nulliparas woman

A

greater than or equal to 1 hour

39
Q

arrest of descent in the multiparas woman

A

greater than or equal to 1/2 hour

40
Q

failure of descent for both nulliparas and multiparas women

A

no change during deceleration phase and second stage

41
Q

precipitous labor in the nulliparas woman

A

greater than 5 cm an hour

42
Q

precipitous labor in the multiparas woman

A

10 cm in an hour

43
Q

cephalopelvic disproportion (CPD)

A

disproportion between the size of the fetus and the size of the mother’s pelvis

44
Q

external cephalic version (ECV)

A

used in an attempt to turn the fetus from a breech or should presentation to a vertex presentation for birth

45
Q

internal version

A

when the hcp puts a hand into the uterus and changes the fetus position for birth

46
Q

What is the bishop score used for

A

to evaluate inducibility