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OB > Chapter 7 > Flashcards

Chapter 7 Flashcards

1
Q

Late preterm infant

A

34-47 weeks

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2
Q

Very preterm infant

A

Less than 32 weeks

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3
Q

Complex factors overlapping influence preterm labor

A

Genetics, medical conditions, environmental, psychosocial, infertility treatments, biological factors

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4
Q

Select factors of preterm labor

A

Drugs, tobacco, stress, low income, infection, domestic violence, age <17>35, IVF pregnancy, PROM

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5
Q

Warning signs of preterm labor

A

Contraction every 10 min or more
Vaginal bleeding, ROM
Pelvic pressure. Backache
Cramps that feel like menstrual period

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6
Q

Dignities of preterm labor

A

> 20 or <37 weeks gestation
6 or more contractions in one hour AND
ROM or cervical dilation change >1 cm or 80% effaced

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7
Q

fFN

A

Fetal fibronectin-
Glue like protein helps the amniotic sac attach to the lining of uterus.
Cannot use if ROM

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8
Q

Contraindications for treating preterm labor

A 
Fetal compromise 
Fetal death
Severe maternal disease 
Active hemorrhage 
Chorioamnionitis
Previable gestation
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9
Q

Prevention of preterm birth

A

Adequate diet
Reduce risk of infection
Eliminate substance abuse
Report to triage if cramps persist

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10
Q

Nursing action immediate care of preterm birth

A 
Hydration 
Fetal monitoring 
UC pattern
Medications 
Obtain fFN, vaginal cultures 
Monitor cervical dilation
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11
Q

Call your doctor or midwife if

A 
Bag of waters breaks
Baby stops moving
Have more than ---- contractions in an hour
Low backache or cramps
Increase discharge 
Fever 100.4
Feel something is not right
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12
Q

Tocolytic drugs

A

May prolong pregnancy for 2-7 days allowing steroids to improve fetal lung maturity or maternal transport to another facility

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13
Q

Magnesium sulfate

A

Relaxes smooth muscle

Loading dose 4-6g in 20 minutes, then 2g/hr

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14
Q

Magnesium sulfate therapeutic level

A

5-8mg/dl

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15
Q

Magnesium sulfate maternal side effects

A

PULMONARY EDEMA, headache, flushing, dry mouth, cardiac arrest, diplopia, weakness

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16
Q

Magnesium sulfate fetal side effects

A

Respiratory depression

Hypotonia

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17
Q

Magnesium sulfate antidote

A

Calcium gluconate

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18
Q

Nursing implications for magnesium sulfate

A

Monitor FHT, UC, serum levels, respirations. Output <30 mL per hour

19
Q

Indomethacin naproxen

A

Depressed synthesis of prostaglandins. Delays delivery for 48+ hours. Used before 32 weeks

20
Q

Indomethacin naproxen doses

A

Loading dose 50 mg oral then 25-50 mg po q6hrs

21
Q

Contraindications of indomethacin naproxen

A

Significant renal and hepatic impairment

22
Q

Side effects of indomethacin naproxen MATERNAL

A

Nausea, heartburn

23
Q

Side effects of indomethacin Naproxen FETAL

A

Ateriousus constriction, pulmonary hypertension, hemorrhages

24
Q

Nifedipine

A

Calcium channel blocker

25
Q

Nifedipine dose

A

10-20 mg PO q4-6 hours

26
Q

Side effects of nifedipine

A

Hypotension, tachycardia, flushing, HA, nausea

27
Q

Contraindications of nifedipine

A

Do NOT use with terbutaline or cardiac disease

28
Q

Nursing with nifedipine

A

May hold dose if BP <90/50

Or HR >120

29
Q

Terbutaline

A 
Beta adrenergic agonist 
Suppress uterine activity 
Meant for asthma 
Can delay delivery for 3 days 
Bronchodilator****
30
Q

Terbutaline FDA warning

A

Injectable not used in pregnant women for prolong or preventable treatment for preterm delivery. Serious maternal heart problems, death

31
Q

Terbutaline dose

A

0.25mg sq q3-4 hrs

IV max dose 0.08mg/min

32
Q

Terbutaline side effects maternal

A

Cardiac, pulmonary edema, MI, hypotension, increase glucose,

33
Q

Terbutaline side effects-fetal

A

Tachycardia
Hyperglycemia
Septal hypertrophy

34
Q

Nursing terbutaline

A

Hold dose if hr >120

Glucose, FHR, UC, I&O, lungs

35
Q

Ritodrine

A

Beta adrenergic agonist

36
Q

Ritodrine dose

A

IV max dose 0.350 mg/min

37
Q

Progesterone

A

Prevent preterm birth for women with a history of spontaneous preterm birth. Not used if multiple gestation

38
Q

Progesterone dose

A

250mg/week starting at 16 weeks to 36 weeks. Not used in multiple gestation

39
Q

Corticosteroid therapy

A

Betamethasone

Stimulates production of more mature surfactant in fetal lungs

40
Q

Betamethasone dose

A

12 mg IM q24 hrs

41
Q

Risk factors for PPROM

A

Sepsis
PTB
Hypoxia
Deformities

42
Q

PPROM diagnosis

A

<37 weeks
+nitrazine
+ ferning
Pooling of amniotic fluid

43
Q

PPROM management

A

Prolong gestation
No infection
Assess lung maturity
Meds

44
Q

Latency

A

Time from membrane rupture to delivery

OB (6 decks)

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