NCM 109: Precipitous Labor and Preterm Labor

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Questions and Answers

What is the definition of precipitous labor and delivery?

Labor lasting less than 3 hours.

List three interventions for managing preterm labor.

Restrict activity, ensure hydration, maintain bed rest and lateral position.

What is the purpose of tocolytics in pregnancy?

To slow or stop contractions of the uterus during pregnancy.

What are the different classes of drugs used for tocolysis?

<p>Betamimetics (such as terbutaline), magnesium sulfate, prostaglandin inhibitors (like indomethacin, ketorolac), calcium channel blockers (such as nifedipine).</p> Signup and view all the answers

What is uterine inversion?

<p>When the uterus completely or partly turns inside out.</p> Signup and view all the answers

Name one assessment finding for uterine inversion.

<p>Depression in the fundal area of the uterus.</p> Signup and view all the answers

What are the causes of early postpartum hemorrhage?

<p>Uterine atony, lacerations, uterine inversion</p> Signup and view all the answers

When does late postpartum hemorrhage occur?

<p>After the first 24 hours of delivery</p> Signup and view all the answers

What is the intervention for late postpartum hemorrhage?

<p>Massage fundus, monitor vital signs and fundus, assess blood loss, administer IV fluids, blood, oxytocin, remain with the client</p> Signup and view all the answers

What is subinvolution in the context of postpartum care?

<p>Incomplete involution or failure of the uterus to return to its normal size and condition</p> Signup and view all the answers

What are the causes of uterine prolapse?

<p>Pregnancy and childbirth, hormonal changes after menopause, obesity, severe coughing and straining on the toilet</p> Signup and view all the answers

What are the symptoms of moderate to severe uterine prolapse?

<p>Seeing or feeling tissue bulge out of the vagina, feeling of heaviness or pulling in the pelvis, feeling like the bladder doesn’t empty all the way, problems with leaking urine (incontinence)</p> Signup and view all the answers

Flashcards

Precipitous Labor

Labor lasting less than 3 hours.

Preterm Labor Interventions

Restrict activity, ensure hydration, maintain bed rest and lateral position.

Purpose of Tocolytics

To slow or stop contractions of the uterus during pregnancy.

Classes of Tocolytic Drugs

Betamimetics, magnesium sulfate, prostaglandin inhibitors, calcium channel blockers.

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Uterine Inversion

When the uterus completely or partly turns inside out.

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Uterine Inversion Assessment Finding

Depression in the fundal area of the uterus.

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Causes of Early Postpartum Hemorrhage

Uterine atony, lacerations, uterine inversion

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Late Postpartum Hemorrhage Timing

After the first 24 hours of delivery.

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Late Postpartum Hemorrhage Intervention

Massage fundus, monitor vitals, assess blood loss, give IV fluids/blood/oxytocin, stay with client.

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Subinvolution

Incomplete involution or failure of the uterus to return to its normal size and condition.

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Causes of Uterine Prolapse

Pregnancy/childbirth, hormonal changes, obesity, severe coughing/straining.

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Uterine Prolapse Symptoms

Tissue bulge from vagina, pelvic heaviness, incomplete bladder emptying, incontinence

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Study Notes

Precipitous Labor and Delivery

  • Defined as labor that lasts less than three hours from the onset of contractions to the delivery of the baby.

Interventions for Managing Preterm Labor

  • Bed rest and hydration to reduce uterine contractions.
  • Corticosteroids for fetal lung maturity if delivery is imminent.
  • Tocolytics to delay labor and improve outcomes for the fetus.

Purpose of Tocolytics in Pregnancy

  • Utilized to suppress premature labor by relaxing uterine muscles, allowing time for fetal development and reducing the risk of complications.

Classes of Drugs Used for Tocolysis

  • Beta-adrenergic agonists (e.g., terbutaline).
  • Calcium channel blockers (e.g., nifedipine).
  • Antiprostaglandins (e.g., indomethacin).

Uterine Inversion

  • Occurs when the uterus turns inside out during or after childbirth, leading to potential hemorrhage and shock.

Assessment Finding for Uterine Inversion

  • Presence of a large, red, and rounded mass protruding from the vaginal opening.

Causes of Early Postpartum Hemorrhage

  • Uterine atony, retained placental fragments, and lacerations of the birth canal.

Timing of Late Postpartum Hemorrhage

  • Occurs more than 24 hours but less than six weeks after delivery.

Intervention for Late Postpartum Hemorrhage

  • Uterine massage and administration of medications to promote uterine contraction; may require surgical intervention in severe cases.

Subinvolution in Postpartum Care

  • Refers to the incomplete return of the uterus to its pre-pregnancy size, potentially leading to prolonged bleeding.

Causes of Uterine Prolapse

  • Weakness of pelvic floor muscles due to childbirth, aging, or obesity.

Symptoms of Moderate to Severe Uterine Prolapse

  • A sensation of heaviness or pulling in the pelvic region, urinary incontinence, and a noticeable bulge from the vaginal opening.

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