Chapter 32: Labor and Birth Complications

Question 1

preterm labor is any birth between ____ and ____ weeks

Answer 1

20:0 ; 36:6

Question 2

very pre-term

Answer 2

<32 weeks

Question 3

moderately pre-term

Answer 3

32-34 weeks

Question 4

late preterm

Answer 4

34:0-36:6 weeks

Question 5

which is more dangerous, preterm birth or low birth weight?

Answer 5

preterm birth because fetal body systems have not fully developed yet

Question 6

low birth weight is considered:

Answer 6

<2500 grams at birth

Question 7

spontaneous preterm births account for what percentage of preterm births?

Answer 7

75%

Question 8

indicated (purposeful) preterm births account for what percentage of preterm births?

Answer 8

25%

Question 9

_______ is the only definitive cause of spontaneous preterm labor

Answer 9

infection of the genital tract

Question 10

a decrease in progesterone might cause:

Answer 10

spontaneous preterm labor

Question 11

what is a fetal fibronectin test

Answer 11

if NO fetal fibronectin is present in the vaginal discharge then that mother has less than a 1% chance of having a preterm labor

Question 12

preterm labor can be prevented in some women by administering prophylactic __________

Answer 12

progesterone

Question 13

short length cervix (15mm-20mm) might cause:

Answer 13

preterm labor

Question 14

if mom is at risk for preterm labor, the following four steps should be taken:

Answer 14

1. transfer to a hospital that is equipped to care for preterm babies
2. administer antibiotics to prevent group B strep
3. administer antenatal glucocorticoids
4. administer magnesium sulfate in women less than 32 weeks

Question 15

what does magnesium sulfate do when given to mothers in preterm labor before 32 weeks

Answer 15

prevent cerebral palsy

Question 16

three major signs of preterm birth are:
1.
2.
3.

Answer 16

1. contractions
2. vaginal discharge
3. pain

Question 17

5 things to do immediately if preterm labor is suspected:
1.
2.
3.
4.
5.

Answer 17

1. stop what you are doing immediately
2. lie down on your side
3. drink two-three glasses of water or juice
4. wait 1 hr
5. call provider or go to birthing facility of symptoms worsen
6. if symptoms go away, inform hcp at next visit
7. call hcp if symptoms return

Question 18

are women who are suspected of preterm labor allowed to have sex?

Answer 18

NO

Question 19

very low birth rate is defined as:

Answer 19

weighing less than 1500 grams at birth

Question 20

extremely low birth weight is defined as:

Answer 20

weighing less than 1000 grams at birth

Question 21

_______ is the number one cause of neonatal and number two cause of infant mortality in the US

Answer 21

prematurity

Question 22

_______ are medications administered to help prolong gestation when preterm labor has started

Answer 22

tocolytics

Question 23

two examples of tocolytics include:
1.
2.

Answer 23

1. beta adrenergic (ritodrine & terbutaline)

2. magnesium sulfate

Question 24

what is the most commonly used tocolytic medication

Answer 24

magnesium sulfate

Question 25

therapeutic range of magnesium sulfate

Answer 25

4.75-5.8 mg/dL

Question 26

what reverses magnesium sulfate toxicity

Answer 26

calcium gluconate

Question 27

commonly used NSAID to prolong gestation in preterm labor

Answer 27

Indomethacin

Question 28

calcium channel blocker given to prolong gestation in preterm labor

Answer 28

Nifedipine

Question 29

nifedipine should never be given with _______ or _______

Answer 29

magnesium sulfate; beta adrenergic (terbutaline)

Question 30

if patient is given Nifedipine, the nurse must instruct her to:

Answer 30

get up slowly, don’t change position too quickly because of orthostatic hypotension

Question 31

_________ is an IM medication that accelerates fetal lung maturity by stimulating fetal surfactant production

Answer 31

antenatal glucocorticoids

Question 32

magnesium sulfate should be given to women who are at least ______ weeks but less than ______ weeks

Answer 32

24;32

Question 33

magnesium sulfate should not be given longer than ____ if birth has not occurred

Answer 33

24 hours

Question 34

dosing for magnesium sulfate includes;

Answer 34

4 g given IV for 30 minutes followed by 1g/hr

Question 35

________ is the spontaneous rupture of the amniotic sac prior to the onset of labor at any gestational age

Answer 35

pre-labor rupture of membranes

Question 36

__________ is the spontaneous rupture of the amniotic sac before 3 weeks

Answer 36

preterm pre-labor rupture of membranes

Question 37

________ is a major risk factor of preterm pre-labor rupture of membranes

Answer 37

infection of urogenital tract

Question 38

_______ is the most common maternal complication of preterm pre-labor rupture of membranes

Answer 38

chorioamnionitis

Question 39

_______ is a bacterial infection caused by preterm PROM

Answer 39

chorioamnionitis