Preventing Preterm Labor Quiz

Psychological Violence

• Refers to acts or omissions causing mental or emotional suffering, including intimidation, harassment, stalking, and public ridicule or humiliation
• Also includes causing or allowing the victim to witness physical, sexual, or psychological abuse of a family member, or witness pornography or abusive injury to pets

Protection Orders

• Barangay Protection Orders (BPO) are issued by the Punong Barangay, effective for 15 days
• Temporary Protection Orders (TPO) are issued by the court, effective for 30 days
• Permanent Protection Orders (PPO) are issued by the court after notice and hearing, effective until revoked

Nursing Intervention

• Therapeutic approach: support the abused woman to develop better self-esteem and make simple decisions
• Greatest risk: 28-year-old G1 at 30 weeks' gestation with high blood pressure and history of cigarette smoking
• Management: prepare for emergency CS

Gestational Conditions

Placenta Previa

• Painless, bright red vaginal bleeding
• No uterine contractions; fetal heart rate within normal range
• Immediate management: determine fetal heart sounds using an external monitor
• Most likely factor: previous CS
• Risk associated: hemorrhage

Gestational Trophoblastic Disease (H-mole)

• Symptoms: dark brown vaginal discharge, grape-like vesicles, nausea, and vomiting
• Risk factors: low protein intake, Asian descent, above 35 years old
• Triad signs: big uterus, hcg of 1 million, vaginal bleeding
• Health teaching: remind the patient not to get pregnant for 1 year

Ectopic Pregnancy

• Symptoms: sudden, stabbing pain in the lower quadrant radiating to the shoulder
• Presence of a Cullen’s sign
• Most common site: fallopian tube

Preterm Labor

• Labor between 20 weeks and 37 weeks gestation
• Management: Betamethasone for fetal lung maturity
• Drug of choice: Magnesium sulfate and Terbutaline to prevent preterm labor progression
• Rh Iso immunization: arrange for Rho(D) immune globulin at 28 weeks' gestation

Cardiac Disease

• Symptoms: cough, FHT of 100 beats per minute with non-reassuring variability, pedal edema
• New York State Heart Association Heart Disease Classification:
  • Class I (uncompromised) can expect a normal pregnancy and birth
  • Class II (slightly compromised) can complete pregnancy with almost complete bed rest
  • Class III (markedly compromised) shortness of breath and easy fatigue
  • Class IV (severely compromised) heart disease are poor candidates for pregnancy
• Left sided heart failure: pulmonary congestion, symptoms mostly seen in changes in respiration
• Peripartum cardiomyopathy: no previous history of heart disease, symptoms of myocardial failure a few weeks before birth

Hyperemesis Gravidarum

• Severe nausea and vomiting leading to electrolyte, metabolic, and nutritional imbalances

PIH and Related Conditions

• Gestational hypertension: hypertension
• Pre-eclampsia: hypertension, edema, proteinuria
• Eclampsia: hypertension, edema, proteinuria, seizure
• Diagnostic test: urinalysis to check for protein
• Management: magnesium sulfate, prepare antedote - calcium gluconate

Postpartum Complications

Uterine Atony

• Prolonged use of Oxytocin

Endometritis

• Infection of the uterus through the vagina, leading to hemorrhage

Uterine Subinvolution

• Delayed postpartum hemorrhage

Cervical Laceration

• Continuous seepage of blood from the vagina of a PP client
• Factors leading to lacerations: primigravida, use of lithotomy position and instruments

Thrombophlebitis

• Fibrinogen level is still elevated from pregnancy, leading to increased blood clotting
• Dilatation of lower extremity veins is still present due to pressure of the fetal head during pregnancy and birth

Disseminated Intravascular Coagulation

• Assess for swelling in the calf in one leg

Infection

• Management: antibiotics
• Nursing intervention: increase fluid intake