Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

PCC4 > Reproduction: Preterm Labor > Flashcards

Reproduction: Preterm Labor Flashcards

1
Q

What are the defining characteristics of preterm labor?

A
  1. labor that begins after the 20th week but before the end of the 37th week
  2. Contractions resulting in cervical change
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the treatment options for preterm labor?

A
  1. bedrest
  2. use of tocolytic drugs
  3. corticosteroids
  4. antibiotic treatments PRN
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the fetal risks/complications of preterm labor?

A
  1. respiratory concerns: potentially life threatening (no surfactant production)
  2. Low birth weight
  3. thermoregulation issues: maintaining body temperature
  4. Feeding problems/hydration/hypoglycemia
  5. fluid/electrolyte imbalances (acidosis)
  6. jaundice
  7. Intraventricular hemorrhage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What medical history risk factors are there for mothers regarding Preterm Labor?

A
  1. Low weight for height
  2. obesity
  3. anomalies (uterine, cervical, or fibroids)
  4. Hx of Cone biopsy
  5. DES exposure as an infant
  6. chronic illnesses (cardiac, renal, diabetes, clotting disorders, anemia, and HTN)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What obstetric history risk factors are there for mothers regarding preterm labor?

A
  1. previous preterm labor/birth
  2. Previous 1st or 2nd-trimester Spontaneous abortion
  3. Hx of previous pregnancy losses (>2)
  4. Placental abnormalities
  5. Incompetent cervix
  6. Number of embryos implanted (if ART used)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What present pregnancy risk factors are there for mothers regarding preterm labor?

A
  1. uterine distention (multiple pregnancies)
  2. abdominal surgery during pregnancy, uterine irritability
  3. uterine bleeding
  4. dehydration
  5. Infection (chorioamnionitis, group B streptococci)
  6. Anemia
  7. Incompetent cervix
  8. Preeclampsia
  9. pPROM
  10. Fetal or placental abnormalities
  11. pyelonephritis
  12. STDs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What lifestyle and demographic risk factors are there for mothers regarding preterm labor?

A
    1. little or no prenatal care
  2. poor nutrition
  3. Age <18 or >40
  4. low educational level
  5. low socioeconomic status
  6. smoking >10 cigarettes/day
  7. employment with long hours
  8. employment with long hours
  9. chronic stress (physical or psychological)
  10. domestic violence
  11. substance abuse
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the diagnosis of preterm labor based on?

A
  1. Clinical evaluation
  2. cervical cultures are done to check for causes suggested by clinical findings (eg. pyelonephritis, STDs)
  3. anovaginal cultures for group B streptococci are done, and prophylaxis is appropriately initiated
  4. most women with a presumptive diagnosis of preterm labor do not progress to delivery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is Fetal Fibronectin (fFN)?

A

A protein that helps the amniotic sac attach to the lining of the uterus.

The body makes fFN early in pregnancy (up to 22 weeks) and again at the end of the pregnancy (about 1-3 weeks before labor starts)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How does the Fetal Fibronectin work?

A
  1. the fFN test measures how much fFN is in the fluids of the vagina and cervix
  2. if the fFN test shows there is no fFN, delivery will probably not occur for another 2 weeks
  3. if the fFN is in the fluid, the provider may use information from an ultrasound or other tests to predict your chances of preterm labor
  4. If the patient is between 24-34 weeks and has fFN in the fluid. That patient is at an increased risk for preterm labor
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What preparation is needed for an fFN test?

A

Nothing should go in the vagina for 48 hours prior to the test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What happens to uterine contractions during preterm labor?

A
  1. frequency of 1 every 10 minutes (6 in one hour)
  2. regular pattern of increasing intensity, duration, and frequency develops
  3. often painless with a sensation of tightening or tingling
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the cervical changes during preterm labor?

A
  1. cervical length (<2.5 cm)
  2. Effacement (>50%)
  3. Dilation (2 cm or >)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What discomfort s/s are associated with preterm labor?

A
  1. low, dull backache
  2. Abdominal or menstrual-like cramping with or without diarrhea
  3. Pelvic pressure (feels like the fetus is pressing down)
  4. Vaginal discharge
  5. Spontaneous Rupture of Membranes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What interventions are used to suppress preterm labor at home?

A
  1. empty bladder
  2. drink 3-4 glasses of water with each being 6-8 ounces
  3. Lie down in a lateral recumbent position
  4. Count contractions
  5. If contractions are not suppressed in one hour, notify the physician
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What interventions are used to suppress preterm labor in the hospital?

A
  1. bed rest in a recumbent position
  2. adequate hydration (2400mL/day oral IV intake)
  3. Regular voiding (every 2 hours)
  4. Interventions to promote relaxation/emotional support
  5. Gather baseline data about maternal, fetal, and labor status in anticipation of tocolytic therapy
17
Q

What medications are often used during preterm labor?

A
  1. antibiotics (for group B streptococci, pending anovaginal culture results)
  2. tocolytics
  3. corticosteroids if gestational age is <34 weeks
18
Q

What do tocolytics do?

A

suppress uterine contractions

19
Q

What is the most serious maternal side effect with tocolytics?

A

pulmonary edema

20
Q

Give some examples of common tocolytics

A
  1. Magnesium sulfate (beta-sympathomimetic)
  2. Terbutaline (Brethine) (beta-sympathomimetic)
  3. Ritodrine (Yutopar) (beta-sympathomimetic)
  4. Indomethacin (Indocin) (prostaglandin inhibitor)
  5. Nifedipine (Procardia) (Calcium Channel Blocker)
21
Q

What are some nursing interventions of beta-sympathomimetics?

A
  1. bed rest and importance
  2. alternate positions in bed (promote circulation)
  3. ROM exercises while in bed
  4. TCDB
  5. Tremors, nervousness, agitation, and restlessness
  6. S/S to notify nurse (tachycardia, chest pain, palpitations)
  7. Accurate I&O/ fluid intake may be limited
  8. monitor VS/DTR every hour is mag
  9. Assess for S/S of pulmonary edema
22
Q

What are some things to report to the physician?

A
  1. maternal HR >120-140, cardiac dysrhythmias
  2. Maternal BP <90/60
  3. Maternal RR< 12/min
  4. FHR >180 bpm
  5. Absences of DTR
  6. Rising Mag levels (above therapeutic)
23
Q

What giving mag sulfate what should a nurse always have available?

A

Calcium Gluconate!

24
Q

How must mag sulfate be given and what should a nurse assess for?

A
  1. MUST use an IV pump
  2. Assess our for s/s of mag toxicity
  3. assess blood levels of mag
25
Q

What are the s/s of mag toxicity?

A
  1. decreased RR
  2. Decreased DTR
  3. Mag higher than the therapeutic range
  4. cardiovascular depression
26
Q

What is the acronym to remember Mag Sulfate Toxicity?

A

BURP

27
Q

What does BURP stand for?

A

Blood pressure decreased
Urine output decreased
Respirations <12
Patella reflex absent

28
Q

What are some nursing considerations with Yutopar (ritodrine)?

A
  1. Give IVPB with pump until UC stop
  2. Can be given long-term PO
  3. Challenges the cardiovascular system (maternal and fetal tachycardia)
  4. Monitor pulse & BP closely; don’t give if pulse is >120
  5. Used infrequently as it does not increase the pregnancy length significantly and because of side effects
29
Q

What are some nursing considerations with Brethin (Terbutaline Sulfate)?

A
  1. give IVPB with a pump to start. Can also be given sub Q or PO
  2. relaxes smooth muscles
  3. assess apical pulse and lung sounds before administering
  4. Consult PCP if pulse >120 and long sounds are wet
30
Q

What are some nursing considerations with Indomethacin?

A
  1. used in early preterm labor (<30 weeks)
  2. Use not recommended after 32 weeks
  3. Used in PTL associated with polyhydramnios
  4. Use is generally limited to 48 hours
  5. monitor I&O (specifically urine output
  6. monitor maternal temp
  7. monitor amniotic fluid index
31
Q

What are corticosteroids used for and how do they work?

A
  1. ordered if birth occurs before 34 weeks gestation

2. May reduce incidence of respiratory distress syndrome and intraventricular hemorrhage in preterm infant

32
Q

What are the most common type of corticosteroids given and what do they do?

A
  1. betamethasone or dexamethasone

2. acceleration of fetal lung maturity

33
Q

How long do they take for them to be effective and how long would we want to hold labor for?

A

24 hours. Delay birth for 24 hours after administration if possible (any time is better than none if not possible)

34
Q

What are the side effects of corticosteroids?

A
  1. nervousness
  2. insomnia
  3. increased need for insulin in the diabetic pregnant woman
35
Q

What are the nursing interventions for corticosteroids?

A
  1. VS (assess for fever and increased HR
  2. lung sounds (pulmonary edema)
  3. look for chest pain/heaviness

PCC4 (38 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions