Hypertensive Complications of Pregnancy Flashcards
exam 2
PROM
premature rupture of membranes
happens before the onset of labor
PPROM
preterm premature rupture of membranes
rupture before 37 weeks
what puts a mother at risk for PROM?
previous preterm, UTI, cervical infection, smoking/substance abuse, hydramnios, post amniocentesis
what are the #1 risk for mom and baby during PROM?
mom - RF infections
baby- RF impaired gas exchange
how to confirm ROM?
visualize, speculum exam, nitrazine, fern test, ultrasound
nursing interventions for PROM that are conservative?
bedrest/reposition
relaxation
NO vaginal exams
maintain hydration
monitor for infection (CBC, temp Q2)
can a woman go home if she has PROM?
yes only if leaking has ceased or is minimal and compliance is anticipated
what at home care is anticipated for PROM?
bedrest
pelvic rest
routine NST
serial CBC
monitor vitals
monitor fetal movement
corticosteroids
decreases RDS in preterm infants
single dose w/ second dose in 24hrs (not repeated)
*increases RF infection
when is immediate birth indicated for PROM?
signs of infection are present
fever, positive gram stain, organisms in amniotic fluid
what social factors put a mother at risk for preterm labor?
domestic abuse, trauma, no prenatal care, extremes in ages
what uterine concerns are RF preterm labor?
multiples, polyhydramnios, uterine fibroids, abnormalities
what is fetal fibronectin?
protein that attaches the amniotic sac to the uterine lining
what does a + fibronectin test indicate?
patient MAY go into preterm labor soon or not for weeks
what does a - fibronectin test indicate?
little possibility of preterm labor for 7-10 days
