Preterm Labor/ Hypertension

Question 1

PROM

Answer 1

premature Rupture of Membranes
-happens before the onset of labor

Question 2

PPROM

Answer 2

Preterm Premature Rupture of Membranes
-rupture before 37 weeks

Question 3

What puts a mother at risk for PROM?

Answer 3

previous preterm, UTI, cervical infection, smoking/substance abuse, hydramnios, post amniocentesis

Question 4

What are the #1 risk for mom and baby during PROM?

Answer 4

mom- RF infections
baby- RF impaired gas exchange

Question 5

How to confirm ROM?

Answer 5

visualize, speculum exam, Nitrazine, Fern, ultrasound

Question 6

Nursing interventions for PROM that are conservative?

Answer 6

-bedrest/reposition
-relaxation
-NO vaginal exams
-maintain hydration
-Monitor for infection (CBC, Temp Q2)

Question 7

Can a woman go home if she has PROM?

Answer 7

Yes, only if leaking fluid has ceased or is minimal and compliance is anticipated

Question 8

What at home care is anticipated for PROM?

Answer 8

bedrest, pelvic rest, monitor vitals, monitor fetal movement, routine NST, serial CBC

Question 9

Corticosteroids:

Answer 9

decreases RDS in preterm infants, single dose w/ second dose in 24 hrs., not repeated, increase RF infection

Question 10

When is immediate birth indicated for PROM?

Answer 10

if signs of infection is present
-Fever, positive gram stain, organisms in amniotic fluid

Question 11

What social factors put a mother at risk for Preterm labor?

Answer 11

domestic abuse, trauma, no prenatal care, extremes in age

Question 12

What uterine concerns are RF Preterm Labor?

Answer 12

multiples, polyhydramnios, uterine fibroids, abnormalities

Question 13

What is Fetal Fibronectin?

Answer 13

protein that attaches the amniotic sac to the uterine lining

Question 14

What does a + fibronectin test indicate?

Answer 14

patient MAY go into preterm labor soon or not for weeks

Question 15

What does a - fibronectin test indicate?

Answer 15

little possibility of preterm labor for 7-10 days

Question 16

Primary Prevention of PTL?

Answer 16

BV, STI, UTI treatment
cervical cerclage
progesterone

Question 17

Secondary prevention of PTL?

Answer 17

early diagnosis, identify as at risk, assessments

Question 18

Ritodrine Hydrochloride

Answer 18

only tocolytic approved by FDA, not used in clinical practice

Question 19

What does Magnesium Sulfate do?

Answer 19

decreases frequency and intensity of contractions

Question 20

Where is magnesium sulfate exclusively given?

Answer 20

hospital use only

Question 21

Mag. Sulf. recommended loading and maintenance dosage?

Answer 21

load- 4-6 g IV in 1000mL IV over 20 min
Maintenance- 1-4 g/hr titrated

Question 22

Magnesium sulfate side effects for mom:

Answer 22

immediate hot flushing, headache, blurred vision, N, dry mouth, dizzy, lethargy, sluggish

Question 23

Magnesium Sulfate side effects for baby:

Answer 23

hypotonia, hypermagnesemia

Question 24

MAg. Sulfate nursing implications:

Answer 24

monitor BP and RR, monitor serum Mag., assess deep tendon reflexes, I&O, LOC, FHR

Question 25

Betamethasone

Answer 25

used w/ tocolytic to speed up fetal lung dev., enhances surfactant production, Deep IM, peak effective 2-7 days after admin

Question 26

What is the 2nd leading cause of maternal death in the U.S.?

Answer 26

Preeclampsia/ Eclampsia

Question 27

Preeclampsia

Answer 27

increased BP after 20 wks, gestation, w/ proteinuria, hypertension

Question 28

Eclampsia

Answer 28

acute and life threatening complication of pregnancy, seizures,

Question 29

Preeclampsia risk factors

Answer 29

Hx of, extremes of age, obesity, primigravida, increased placental mass, multiples, diabetes, kidney disease, chronic hypertension

Question 30

What is the only “cure’ for preeclampsia?

Answer 30

birth of the fetus