Labor and Birth Complications

Question 1

Preterm Labor

Question 2

Postterm Labor

Question 3

Preterm Premature Rupture of Membranes

(PPROM)

Question 4

Risk Factors for Preterm Labor

Medical History

Question 5

Risk Factors for Preterm Labor

Obstetric History

Question 6

Risk Factors for Preterm Labor

Present Pregnancy

Answer 6

• Short cervical lengnth or cervical insufficiency
• Uterine distention
• Preeclampsia/eclampsia and/or gestational diabetes
• Poor nurtion and/or anemia during pregnancy
• time between pregnacnies < 1 year
• Preterm PROM
• Infections
  
  • STIs
  • Chorioamniotis
  • UTIs
• Low pregnacny weight gain
• Fetal or placental abnormalies

Question 7

Risk Factors for Preterm Labor

Demographics/Lifestyle

Question 8

Diagnostic methods for Preterm labor

Question 9

Fetal Fibronection level

Question 10

Salivary estriol

Question 11

Cervical length

Question 12

Subjective data

Question 13

Nitrazine or Fern test

Question 14

Who should be considered at risk for preterm labor

Question 15

Signs and Symptoms of preterm Labor

Answer 15

• Uterine activity
  
  • ​Uterine contractions occuring more frequently than ever 10 minutes persiseting for 1 hour or more
  • Uterine contractiosn may be painful or painless
• Discomfort
  
  • ​Lower abdominal cramping, similar to gas pains; may be accompanined by diarrhea
  • Dull intermittent low back pain
  • Painful menstrual like cramps
  • Suprapubic pain and pressure
  • Pelvic pressure or heaviness; feeling that the “baby is pushing down”
  • Urinary frequency

Question 16

What to Do If Symptoms of Preterm Labor Occur

Answer 16

• Empty your bladder
• Drink two or three glasses of water or juice
• Lie down on your side for 1 hour
• Palpate for contractions
• In symptoms continue, call your doctor or go to the hospital
• If symptoms go away, resume light activity, but not what you were doing when the symptoms began
• If symptoms return go to the hospital
• if any of the following occur call your health care provider immediately:
  
  • Uterine contractions every 10 minutes or less for 1 hour or more
  • Vaginal bleeding
  • Odorous vaginal discharge
  • Fluid leaking from vagina

Question 17

Nursing Diagnosis For Preterm Labor

Question 18

Nursing Interventions for Preterm Labor

Question 19

Activity restrictions

Question 20

What are Tocolytics

Question 21

Goal of tocolytic therapy

Question 22

Commonly Used Tocolytics

Question 23

Magnesium Sulfate

What does it do

Question 24

Magnesium Sulfate Toxcitiy Warning Signs

Question 25

What drug should you give for Magensium Sulfate toxicity

Question 26

Ritodrine and Terbutaline

Question 27

What should the maternal heart rate be when recieving Terbutaline

Question 28

Nuring Care for Patients receiving Tocolytic Therapy

Question 29

Nifedipine

Question 30

Calcium channel blocker nursing alert

Question 31

Indomethacin

Question 32

Antenatal Glucocorticoids

Question 33

Premature Rupture of Membranes likely results from

Question 34

How is PROM or PPROM diagnosed?

Question 35

What is the most common maternal complication of Preterm PROM

Question 36

Less Common Serious Maternal Complications of PROM

Question 37

Fetal Complications from PPROM are ripmarily related to what

Question 38

Care Management of PROM

Question 39

Education after preterm PROM

Question 40

Chorioamnionitis | (intrapartum infection)

Answer 40

* Bacterinal infection of the amniotic cavity * Major casue of complications for both mother and newborns *

Question 41

Dystocia | (Dysfunctional Labor)

Question 42

Causes of dystocia

Answer 42

* Ineffective uterine contractions (powers) * Alterations in the pelvic structure (passage) * Fetal casues (passenger) * abnormal presentation or position * anomalies * excessive size * more than one fetus * Maternal position during labor and birth

Question 43

Dysfunctional labor is suspected when

Question 44

Factors that increase a womans risk of dystocia

Question 45

Abnormal uterine acitivty can be describe ad being

Question 46

Hypertonic Contractions

Question 47

Treatment options for Hypertonic Contractions

Question 48

Hypotonic Uterine Contractions

Answer 48

* Contractions become weak and ineffective or stop all together * Intrauterine pressure during the contraction is usually less than 25 and is insufficent for progress of cervical effacement and dilation * CPD and malposition are common casues * Increased risk of infection * May be related to over streched over used uterus * medications * Maternal age * Cervical ridgity * Can lead too *

Question 49

Precipitious Labor

Question 50

Fetal Causes of Dystocia

Question 51

Cephalopelvic disproportion (CPD)

Question 52

Malposition

Question 53

Measures to facilitate rotation of the fetal head

Question 54

Malpresentation

Question 55

Breech Position

Answer 55

* Frank breech -hips flexed knees extended * Complete breech- hips and knees flexed * Footling breech- one or both feet present before butt * Associated with multifetal gestation, preterm birth, fetal or maternal maomalies, hydramnios, plioghydraminios * Labor prologed becasue the butt doesnt cause effective cervical dilation like the head * Risk of prolabose cord * meconium stained amniotic fluid is a risk * Assess FHR *

Question 56

Face and brow presentation

Question 57

Shoulder presentation | (transverse lie)

Question 58

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