Preventing Preterm Labor Quiz
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Questions and Answers

What is the most appropriate immediate management for the patient described?

  • Perform an ultrasound to assess placental location
  • Start intravenous oxytocin for induction of labor
  • Administer Betamethasone for fetal lung maturity
  • Prepare for emergency cesarean section (correct)

    • Which factor is most likely contributing to the risk of hemorrhage in this patient?

  • Previous cesarean section (correct)
  • Preterm labor
  • Gestational trophoblastic disease
  • Ectopic pregnancy

    • What are the triad signs associated with gestational trophoblastic disease?

  • Sudden, stabbing pain, Cullen's sign, shoulder pain
  • Big uterus, hCG of 1 million, vaginal bleeding (correct)
  • Dark brown vaginal discharge, grape-like vesicles, nausea
  • Low protein intake, Asian ethnicity, age below 35

    • In preterm labor, at what gestational age range does it typically occur?

    <p>Between 20-37 weeks gestation</p> Signup and view all the answers

    What is the most common site for an ectopic pregnancy to occur?

    <p>Fallopian tube</p> Signup and view all the answers

    What is the indication for using Betamethasone in pregnancy?

    <p>Fetal lung maturity in preterm labor</p> Signup and view all the answers

    What does psychological violence refer to?

    <p>Mental or emotional suffering caused to the victim</p> Signup and view all the answers

    Which of the following is an example of economic abuse?

    <p>Controlling the victim's access to money or resources</p> Signup and view all the answers

    What is the purpose of a Temporary Protection Order (TPO)?

    <p>To provide immediate protection to the victim</p> Signup and view all the answers

    What does a Permanent Protection Order (PPO) require for issuance?

    <p>Notice and hearing in court</p> Signup and view all the answers

    Which of the following does NOT constitute psychological violence?

    <p>Physical harm to property</p> Signup and view all the answers

    What kind of support might an abused woman need until she can develop better self-esteem?

    <p>Support to enhance her decision-making skills</p> Signup and view all the answers

    What is the drug of choice to prevent preterm labor from progressing?

    <p>Magnesium sulfate and Terbutaline</p> Signup and view all the answers

    When should RhoGAM be administered for a woman affected by Rh incompatibility?

    <p>Within 72 hours after delivery of an Rh + baby</p> Signup and view all the answers

    What is the management for a pregnant woman with Class III (markedly compromised) heart disease?

    <p>Complete bed rest and avoiding ordinary activity</p> Signup and view all the answers

    What is the management for an Rh-negative mother with a Rh-positive fetus?

    <p>Administer Rho(D) immune globulin at 28 weeks' gestation</p> Signup and view all the answers

    What symptoms would a pregnant woman with Class IV (severely compromised) heart disease exhibit?

    <p>Shortness of breath and easy fatigue even at rest</p> Signup and view all the answers

    What is the standard treatment protocol for a pregnant woman with no rupture of membranes and mild cramping?

    <p>Admission to the hospital, bed rest, and tocolytic agent</p> Signup and view all the answers

    What symptoms are mostly seen in left-sided heart failure related to pulmonary congestion?

    <p>Shortness of breath and a cough that produces blood-speckled sputum</p> Signup and view all the answers

    What symptoms may a pregnant woman with peripartum cardiomyopathy exhibit?

    <p>Shortness of breath and chest pain</p> Signup and view all the answers

    Which condition is characterized by hypertension, edema, and proteinuria during pregnancy?

    <p>Pre eclampsia</p> Signup and view all the answers

    What should be avoided with a patient experiencing seizures due to eclampsia?

    <p>Placing the patient in a supine position</p> Signup and view all the answers

    What diagnostic test is recommended for checking protein levels during pregnancy-induced hypertension?

    <p>Urinalysis</p> Signup and view all the answers

    What should a nurse prioritize when managing a pregnant woman with mitral valve stenosis?

    <p>Administering an anticoagulant</p> Signup and view all the answers

    What is the most likely cause of hemorrhage postpartum?

    <p>Uterine Atony</p> Signup and view all the answers

    Which factor is most likely to lead to genital tract laceration during birth?

    <p>Birth of a large baby</p> Signup and view all the answers

    What should a nurse assess first when evaluating a postpartum client's uterus?

    <p>Height and tone</p> Signup and view all the answers

    What can continuous seepage of blood from the vagina along with a firm uterus indicate in a postpartum client?

    <p>Cervical laceration</p> Signup and view all the answers

    Which condition is characterized by swelling in the calf of one leg?

    <p>Thrombophlebitis</p> Signup and view all the answers

    What nursing intervention is typically recommended for managing postpartum infection?

    <p>Increase fluid intake</p> Signup and view all the answers

    Study Notes

    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
    • 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

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    Description

    Test your knowledge on preventing preterm labor, managing mild cramping, and addressing Rh Iso immunization. Learn about the use of Magnesium sulfate, Terbutaline, and Rho(D) immune globulin in such scenarios.

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