Preterm Labor Overview

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Questions and Answers

What is a potential complication that may arise from intrauterine infections during pregnancy?

  • Increased gestational weight
  • Decreased fetal movement
  • Umbilical cord compression or prolapse (correct)
  • Prolonged labor

What laboratory test result indicates the presence of amniotic fluid leakage?

  • Normal vaginal culture findings
  • High maternal blood pressure
  • Negative nitrazine paper test
  • Positive ferning test on amniotic fluid (correct)

What nursing care intervention should be prioritized for a patient with possible premature rupture of membranes?

  • Obtain vaginal cultures for sexually transmitted infections (correct)
  • Implement continuous fetal monitoring
  • Provide unrestricted access to food and fluids
  • Encourage patient to engage in physical activity

Which medication is typically prescribed for a pregnant patient at risk of infection due to premature rupture of membranes?

<p>Ampicillin (A)</p> Signup and view all the answers

What self-care measure should be advised to a patient experiencing potential issues related to premature rupture of membranes?

<p>Limit activity but allow bathroom privileges (D)</p> Signup and view all the answers

What is a common complication associated with intrauterine infections?

<p>Fetal pulmonary hypoplasia (B)</p> Signup and view all the answers

What indicates a positive nitrazine paper test result?

<p>Changes to blue with a pH of 6.5 to 7.5 (D)</p> Signup and view all the answers

Which medication is commonly prescribed for treating infections during pregnancy?

<p>Ampicillin (B)</p> Signup and view all the answers

What is an appropriate nursing care action for a patient with suspected rupture of membranes?

<p>Encourage hydration (D)</p> Signup and view all the answers

Which of the following is included in client education for patients with suspected preterm labor?

<p>Perform self-assessment for uterine contractions (B)</p> Signup and view all the answers

Which of the following is NOT a risk factor for preterm labor?

<p>High prepregnancy weight (D)</p> Signup and view all the answers

What is a common finding associated with preterm labor?

<p>Persistent low backache (B)</p> Signup and view all the answers

Which medication is used as a tocolytic to suppress contractions during preterm labor?

<p>Terbutaline (B)</p> Signup and view all the answers

What laboratory test is used to identify shortened endocervical length in potential preterm labor cases?

<p>Ultrasound assessment (B)</p> Signup and view all the answers

Which of the following statements about Betamethasone is correct?

<p>It enhances fetal lung maturity and surfactant production. (A)</p> Signup and view all the answers

Which of the following is a necessary component of nursing care for a patient experiencing preterm labor?

<p>Ensuring hydration (D)</p> Signup and view all the answers

What does the presence of fetal heart rates greater than 160 often indicate in terms of complications during labor?

<p>Potential maternal infection (D)</p> Signup and view all the answers

Which condition refers to the spontaneous rupture of membranes before labor begins?

<p>Preterm Premature Rupture of Membranes (PPROM) (D)</p> Signup and view all the answers

Which of the following are considered risk factors for preterm labor?

<p>Advanced maternal age (B), Smoking (D)</p> Signup and view all the answers

What symptom might indicate preterm labor?

<p>Persistent low backache (D)</p> Signup and view all the answers

Which diagnostic test is commonly used to assess the risk of preterm labor?

<p>Fetal fibronectin (C)</p> Signup and view all the answers

What medication is administered to enhance fetal lung maturity in cases of preterm labor?

<p>Betamethasone (C)</p> Signup and view all the answers

Which of the following is NOT a finding associated with preterm labor?

<p>High fever (D)</p> Signup and view all the answers

What is a common nursing intervention for managing preterm labor?

<p>Activity restriction (C)</p> Signup and view all the answers

Which condition is characterized by spontaneous rupture of the membranes before labor begins?

<p>Early rupture of membranes (B)</p> Signup and view all the answers

What is a risk factor specifically associated with Preterm Premature Rupture of Membranes (PPROM)?

<p>Infection (D)</p> Signup and view all the answers

Flashcards

Premature Rupture of Membranes (PROM)

Accidental leakage of amniotic fluid before labor begins.

Nitrazine Paper Test

A test used to identify amniotic fluid leakage by checking pH.

Nursing Care for PROM

Care for a patient with premature rupture of membranes (PROM) to prevent infection and complications.

Potential Complications of PROM

Possible outcomes of premature rupture of membranes, including infection, umbilical cord issues, and fetal lung problems.

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Essential Client Education for PROM

Instructions given to a patient with premature rupture of membranes to guide self-care and monitoring.

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Preterm Labor Risk Factors

Conditions increasing the chance of childbirth before 37 weeks of pregnancy.

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Preterm Labor Findings

Signs and symptoms a pregnant woman may experience that suggest possible preterm labor.

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Fetal Fibronectin Test

A test to evaluate the presence of a protein in vaginal secretions related to preterm labor risk.

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Tocolytics (e.g., Nifedipine)

Medications used to stop or delay preterm labor by relaxing uterine muscles.

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Magnesium Sulfate's Role

A preventative medicine for preterm labor, acting as a central nervous system depressant to lessen contractions.

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PROM (Premature Rupture of Membranes)

The premature breakage of the amniotic sac before the start of labor, usually between 20 and 37 weeks.

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Chorioamnionitis

Infection of the amniotic sac, often a factor in preterm labor.

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Betamethasone's Function

A medication administered to promote fetal lung development in preterm babies (24-34 weeks).

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Preterm Labor

Labor that occurs before 37 weeks of pregnancy.

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Risk Factors for Preterm Labor

Conditions that increase the likelihood of preterm labor, such as infections, previous preterm birth, and smoking.

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Findings of Preterm Labor

Symptoms that indicate potential preterm labor, including contractions, pelvic pressure, and backache.

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Fetal Fibronectin

A protein found in cervical mucus that can indicate preterm labor risk.

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Magnesium Sulfate

A medication used to slow down or stop preterm labor.

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Betamethasone

A steroid given to pregnant women to help the baby's lungs mature.

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Risk Factors for PROM

Factors that increase the chance of the amniotic sac breaking too early, such as infections and previous preterm births.

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What's a positive nitrazine test indicate?

It suggests a rupture of membranes. The nitrazine paper turns blue due to the high pH of amniotic fluid (6.5 to 7.5).

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What's a 'ferning' test?

It's another way to confirm ruptured membranes. Microscopic examination of amniotic fluid reveals a fern-like pattern.

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Why are vaginal exams limited with PROM?

To reduce the risk of infection. Each exam increases the chance of introducing bacteria into the amniotic sac.

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What's the most common complication of PROM?

Intrauterine infection is the most frequent concern, increasing the risk of sepsis for both the mother and the fetus.

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What are possible outcomes of PROM?

Besides infection, it can lead to umbilical cord compression, fetal lung problems, and even death. Immediate attention is crucial.

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Study Notes

Preterm Labor

  • Risk Factors: Urinary tract or vaginal infections, HIV, herpes, intrauterine infections, prior preterm births, multifetal pregnancies, smoking, substance use, violence, lack of prenatal care, uterine abnormalities, low pre-pregnancy weight, advanced maternal age
  • Findings: Uterine contractions, pelvic pressure, menstrual-like cramping, persistent low backache, gastrointestinal cramping (sometimes with diarrhea), urinary frequency, vaginal discharge

Laboratory Tests/Diagnostic Procedures

  • Fetal fibronectin
  • Complete Blood Count (CBC)
  • Cervical cultures
  • Urinalysis
  • Vaginal swabs
  • Measurement of shortened endocervical length (with a UA)
  • Cervical cultures
  • Biophysical profile

Nursing Care

  • Activity Restriction
  • Ensuring Hydration
  • Chorioamnionitis Identification and Treatment
  • Monitoring Fetal Heart Rate (FHR) and Contraction Patterns (FHR greater than 160 may indicate infection)
  • Identification and treatment of infections

Medications

  • Nifedipine (calcium channel blocker, suppresses contractions)
  • Magnesium Sulfate (central nervous system depressant that relaxes smooth muscles)
  • Terbutaline

Early Rupture of Membranes (PROM)

  • Definition: Spontaneous rupture of the amniotic membranes prior to the onset of true labor
  • Preterm Premature Rupture of Membranes (PPROM): Rupture of membranes after 20 weeks of gestation and before 37 weeks.

Risk Factors (PROM)

  • Infection
  • Prior preterm birth
  • Cervical shortening
  • Second/third trimester bleeding
  • Pulmonary or connective tissue disorders
  • Low Body Mass Index (BMI)
  • Copper or ascorbic acid deficiencies
  • Tobacco or substance use

Findings (PROM)

  • Leakage or gush of clear fluid from the vagina
  • Nitrazine paper test (positive if blue, pH 6.5-7.5)
  • Ferning of amniotic fluid (presence of fern-like pattern under a microscope).

Nursing Care (PROM)

  • Preparation for birth if indicated
  • Obtaining vaginal/rectal cultures (streptococci, chlamydia, gonorrhoea)
  • Limiting vaginal exams
  • Providing reassurance
  • Vital signs every 2 hours (VS)
  • Temperature monitoring (>100°F) notification to provider
  • Fetal heart rate and uterine contractions monitoring
  • Encouraging hydration
  • Obtaining a complete blood count (CBC)
  • Anticipating prescription for seven-day antibiotics

Complications (Early Onset of Labor)

  • Infection: Intrauterine infections are most common
  • Other complications: Umbilical cord compression or prolapse, fetal pulmonary hypoplasia, death

Client Education

  • Limited activity with bathroom privileges
  • Hydration
  • Self-assessment for uterine contractions
  • Record daily fetal movement counts
  • Monitor for foul-smelling vaginal discharge
  • No sexual activity
  • Avoid tub baths
  • Wipe from front to back
  • Temperature monitoring (>100°F) notification to provider every 4 hours.

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