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Maternal Nursing > Preterm Labor and Infants > Flashcards

Preterm Labor and Infants Flashcards

1
Q

What is preterm labor?

A

Any true labor experienced between 20 and 37 weeks

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2
Q

What does true labor include?

A

Cervical change, dilation of 2cm+, 80% effacement, and uterine contractions.

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3
Q

What is premature rupture of membranes?

A

Rupture of amniotic sac and leakage of fluid beginning before the onset of labor at any gestational age

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4
Q

What is preterm premature rupture of membranes (PrePROM)?

A

ROM before 37 weeks gestation. Unknown etiology, possibly because of weak membrane or inflammation

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5
Q

What does a prePROM put the mother and infant at risk for?

A

Infection, placental abruption, cord prolapse

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6
Q

What are the two most common biochemical markers?

A

Fetal Fibronectin and Salivary Estriol

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7
Q

What is Fetal Fibronectin?

A

Glycoproteins found in plasma and fetal live found between 24 and 34 weeks

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8
Q

What is Salivary Estriol?

A

A form of estrogen that is produced by the placenta and increases 2-3 weeks before labor

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9
Q

What does the endocervical length have to do with predicting preterm labor?

A

A shortened length may increase changes of preterm labor.

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10
Q

What are risk factors of pre term labor?

A

Spontaneous preterm birth, african american race, multifetal pregnancy, genital infection, 2nd trimester bleeding, low prepregnancy weight, smoking, no prenatal care

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11
Q

What are signs and symptoms of pre term labor?

A

Uterine contractions greater than every 10 minutes, lower back pain, pelvic pressure, cramps, urinary frequency, vaginal discharge change, trickle from ROM

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12
Q

What is the criteria for treatment of pre term labor?

A

Contractions with progressive change in cervice, dilation 2-4 cm, effaccement 80%+, fetus is viable

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13
Q

Management for pre term labor patients

A

Limited activity, modified bedrest, 2L of fluid/day, urinate frequently, limit sex, visit HCprovider.

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14
Q

Management for PrePROM patients

A

Assess for infection, assess for uterine contraction, count fetal movement, no baths, antibiotics

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15
Q

Management in the hospital for patients

A

Modified bedrest, hydrate, meds, fetal monitoring

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16
Q

What do beta andrengic agents do?

A

Relax smooth muscle inhibiting uterine activite- Terbutaline (Brethine)

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17
Q

What does magnesium sulfate do?

A

Depresses CNS relaxing smooth muscle in uterus, inhibits contractions

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18
Q

What do calcium channel blockers do?

A

Reduce contractions, inhibits calcium movement to smooth muscle- Nifedipine (Procardia)

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19
Q

What do prostaglandin inhibitors do?

A

Relax smooth muscles including uterus- Indomethacin (indocin)

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20
Q

When are glucocorticoids not recommended?

A

If a cord has prolapsed, chorioamnionitis, abruptio placenta

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21
Q

What do glucocordicoids do?

A

Stimulate fetal lung maturation and promote release of enzyme to produce or release surfactant (Betamethasone and Dexamethasone)

22
Q

When are antibiotics given?

A

To treat maternal infections- group B Strept and chorioamnionitis- Penicillin unless allergy or ampicillin

23
Q

Etiology of preterm birth

A

Unknown- cervical insuffiency, PPROM, infections

24
Q

What weight is a low birth weight infant?

A

Under 2500 g

25
Q

What weight is an extremely low birth weight infant?

A

under 1000 g

26
Q

What age is a preterm infant?

A

less than 37 weeks

27
Q

What age is a late preterm infant?

A

34-37 weeks

28
Q

What are characteristics of preterm infants?

A

Transparent/fragile skin, little/no lanugo, increased vernix, fused eyelids, flat and poor recoiled ears, smooth male scrotum, prominent labia minor and clitoris

29
Q

What should you assess in a preterm infant?

A

Everything- respiratory, cardiac, temperature, CNS function, renal function, nutrition status, blood studies, infection prevention

30
Q

What is Respiratory Distress Syndrome?

A

When the lungs are immature and there is a lack of surfactant.

31
Q

What are signs and symptoms of Respiratory Distress Syndrome?

A

Cyanosis, Tachypnea, grunting, nasal flaring, retractions, apnea, atelectasis

32
Q

How do you manage RDS?

A

Maintain airway, ventilation, and oxygenation, surfactant therapy- watch O2 Levels

33
Q

Nursing Care for RDS

A

Assess degree of respiratory distress, evaluate response to therapy, warm humidified oxygen as per order, wean from o2

34
Q

What is Apnea of Prematurity?

A

Periods of apnea for >20 seconds that may or may not be associated with bradycardia, desaturations, or color change

35
Q

What is treatment for apnea of prematurity?

A

caffeine, CPAP, or mechanical ventilation

36
Q

What is Bronchopulmonary Dysplasia (BPD)?

A

Lung damage resulting from long term mechanical ventilation. Recovery can take months with complications.

37
Q

How do you treat Bronchopulmonary Dysplasia?

A

PREVENT! Bronchodilator, diuretics, steriods

38
Q

What is Retinopathy of Prematurity (ROP)?

A

An aquired disease of the blood vessels of the retina resulting in an eye injury with possible blindness.

39
Q

What is the etiology or cause of ROP?

A

Changes in retinal vasculature due to abnormal blood vessel growth in response to high levels of O2, retinal immaturity, and exposure to light

40
Q

How to you treat ROP?

A

Maintain SpO2 in target range, eye exams, laser surgery to prevent detachment.

41
Q

What is Necrotizing Enterocolitis (NEC)?

A

Acute inflammation of the bowel from ischemic injury to intestinal mucosa, presence of bacteria, feedings, immature GI tract.

42
Q

What are risk factors associated with NEC?

A

Asphyxia, hypoxia, extremely low birth weight

43
Q

What are symptoms of NEC?

A

Feeding intolerance, abdominal distension, blood in stool, lethargic, VS instability

44
Q

How do you treat NEC?

A

NPO, suction, antibiotics, colostomy/bowel repair

45
Q

What is Intraventricular Hemorrhage (IVH)?

A

Bleeding around or into the ventricular system of the brain- fragile blood vessels rupture easily in response to sudden changes

46
Q

What are symptoms of IVH?

A

Apnea, flaccidity, full fontanel

47
Q

What is the treatment of IVH?

A

Minimize trauma and discomfort, stress, and heat loss, assess seizure activity, measure head circumference

48
Q

What should you assess related to nutrition?

A

Glucose levels, swallowing, I&O, Calories, weights

49
Q

What is gavage feeding?

A

Feeding into the stomach

50
Q

What should you take into consideration when planning discharge?

A

Home care needs, knowledge deficits, referrals for resources and home health assistance, resources for equipment, transportation

51
Q

What do parents need special instruction and teaching on before taking their premie home?

A

CPR, O2 therapy, suctioning, feeding, NG tube care, colostomy, follow up appointments

Maternal Nursing (22 decks)

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