Nursing Care of a Family Experiencing a Sudden Pregnancy Complication Flashcards
What is preterm labor?
Occurs before the end of week 37 of gestation
Occurs 9% to 11% of all pregnancies
Responsible for 2/3 of all infant death in the neonatal period
Give the S/S of preterm labor
- Persistent uterine contractions
- Persistent, low, back ache
- Vaginal Spotting
- Menstrual-like cramp
- increased vaginal discharge; uterine contractions; intestinal cramping
What are the contributing factors of preterm labor?
- Socioeconomic status
- Medical/ OB history
- Lifestyle
- Risk of current pregnancy
what are the therapeutic management for preterm labor
- Bed rest
- Tocolytic Therapy
- Glucocorticoid Therapy - dexamethasone
Difference between tocolytics and uterotonics [give examples each]
tocolytics - decrease uterine contraction [Magnesium Sulphate, Indomethacin]
Uterotonics - increase uterine contraction [oxytocin]
what are the signs of preterm labor that cannot be halted?
- Membranes have ruptured
- Cervix is effaced more than 50%
- Cervix is more than 3-4 dilated
*
the test for the acidity/alkalinity of the amniotic fluid
Nitrazine test
microscopic examination of the fluid
Ferning
Amniotic Fluid Index’s normal range: _____ cm (below _ is low)
5-24cm, below 5 is low
what is the therapeutic management for when there is a premature rupture of membranes
- Labor does not begin within 24 hours, fetus is estimated to be mature to survive, labor is induced by IV administration of oxytocin (so the infant can be born before infection can occur).
- If fetus is not at a point of viability– immediate delivery of baby to end the pregnancy OR
Bed rest until she reaches viability (20 - 24 weeks) - Corticosteroids to hasten fetal lung maturity - dexamethasone
*Antibiotics to reduce risk of infection, allow corticosteroids to have its effect
give me other terms for postterm pregnancy
POST MATURE / POSTDATE
how can a pregnancy be considered as post term?
when it goes beyong 42 weeks of gestation
a term used when the uterus does not respond to labor stimulation
myometrial quiescence
what are the etiologic factors associated with post term pregnancy
- Faulty due date
- Trigger that initiates labor did not turn on
- Woman receiving a high dose of Salicylate (eg. aspirin for pain)
- May be associated w/ myometrial quiescence - uterus does not respond to labor stimulation
when mother is already in the postpartum preganancy, what are the fetal risk at stake?
- Meconium aspiration
- Increasing size and hardening of skull may
contribute to CPD - Decreased Placental Function
- Cord Compression during labor
maternal risk when mom is postpartum pregnant.
[therapeutic management for postpartum preggy?]
- Chorioamnionitis
- Severe perineal lacerations
- Cesarean delivery rates (CS has more complications than NSVD)
- Postpartum hemorrhage
- Endomyometritis
[Induction of labor, Cesarean delivery]
If expectant management is chosen, the fetus should be monitored with twice-weekly of ______ (eg. fetal kicks), amniotic fluid index, or biophysical profile. However, evidence of benefit is lacking.
Non stress test
If ________ is present in a woman with post-term pregnancy, delivery is indicated.
oligohydramnios
Normal Amount Amniotic Fluid - _______ml
Polyhydramnios - _____ml
Oligohydramnios - ____ml
500-200 ML
Above 2000 ml
Below 500ml
condition in which vasospasm occurs in both small and large arteries during pregnancy, causing increased blood pressure.
Gestational Hypertension
occurs in 5% to 7% of pregnancies.
PIH
pregnancy-related disease process evidenced by increased blood pressure and proteinuria
Preeclampsia
what are the risk factor of PIH
- Women of color
- Primiparas younger than 20 years or older than 40 years of age
- Women from low socioeconomic backgrounds
- Had 5 or more pregnancies (grand multipara)
- Have polyhydramnios
- Have underlying disease, such as heart disease, diabetes with vessel or renal involvement, essential hypertension
