Preterm Birth and Labor

Question 1

What is Preterm Labor

Answer 1

Any TRUE labor that is 20-37weeks gestation

Question 2

what is true labor

Answer 2

• cervical changes

* uterine contractions

Question 3

Preterm infant (time in weeks)

Answer 3

anyone born before 37 weeks

Question 4

Low Birth Weight Infant

Answer 4

2500 grams

5.5 lbs

Question 5

extremely low borth weight infant

Answer 5

less than 1000 grams, 1kg, 2.2 lbs

Question 6

risk factors of premature birth/labor (3)

Answer 6

• demographic
• biophysical
• behavioral- psychosocial

Question 7

How would you educate a pregnant mother to avoid premature birth/labor?

Answer 7

maintain proper nutrition

Question 8

Biochemical Markers of Preterm Birth and Labor (2)

Answer 8

Fetal Fibronectin; Salivary Estriol

Question 9

What is Fetal Fibronectin

Answer 9

glycoprotein found in the plasma, 24-34 weeks timeframe, produced in cervical canal; tested during vaginal exams

Question 10

Salivary Estriol

Answer 10

Estrogen secreted by the placenta

Question 11

Diagnosis of PreTerm Labor (3)

Answer 11

• Gestational Age (20-37 weeks)
• Onset of contractions
• cervical changes (effacement, dilation)

Question 12

Criteria for treatment of preteram labor

Answer 12

dilation 2-4 cm
effacement of 80%+
informed consent

Question 13

Danger of Tocolytic Drugs

Answer 13

caution when pt is put on IV lfuids; strict I/O. should be between 1500-2400 mL/24hrs

Question 14

Beta Adrenergic Agents

Answer 14

relaxes smooth muscles, stops uterine activity
side effects: ^^ HR

Ex. Brethine, Yutopar

Question 15

Magnesium Sulfate

Answer 15

BLACK BOX WANING
give with a bronchodilator
stops seizure from occurring

Question 16

Corticosteroids (given for what)

Answer 16

stimulate fetal lung maturation

promotes the release of surfactant

Question 17

Corticosteroids (when not recommended)

Answer 17

• cord prolapse
• chorioamnionitis
• placental abruption

Question 18

Corticosteroids Nursing Considerations

Answer 18

• check blood glucose levels

* assess for cushing syndrome

Question 19

Antibiotics for Maternal Infections

Answer 19

Ampicillin. If allergic, give Vancomycin

Question 20

Premature Rupture of Membranes (PROM)

Answer 20

leakage of amniotic fluid for at least 1 hr before labor

Question 21

how can you tell the differnce between amniotic fluid and regular vaginal discharges?

Answer 21

amniotic fluid has a “fern” shape when observed under microscope

Question 22

PROM

Answer 22

Premature Rupture of Membranes

Happens before 37 weeks

Question 23

What do you assess for in PROM

Answer 23

prolapse of cord

Question 24

Home Nursing Care of Pregnant Mother

Answer 24

• maintain BP
• do not insert anything in vagina
• monitor kick counts
• no tub baths

Question 25

Delivery of Preterm Infant/ Maternal Complications

Answer 25

* C Section highly recommended | * Mother at risk for Post Partum Hemorrhage

Question 26

Characteristics of Preterm Infant (physical appearance)

Answer 26

* eyelids fused shut * ears coiled * smooth male scrotum * very prominant labia and clitoris

Question 27

Ballard Gestational Scale

Answer 27

Using neuromuscular and physical assessments, determine the overall condition of the newborn

Question 28

Hyaline Membrane Disease (H.M.D)

Answer 28

immature lungs and lack of surfactant | respiratory distress for first 24hrs of life

Question 29

Signs and Symptoms of HMD

Answer 29

* cyanosis * tachypnea * grunting

Question 30

NewBorn Respiratory Assessment

Answer 30

brady: less than 30 breaths/min * tachy: more than 60/min * nasal flaring * labored breathing

Question 31

HMD Management

Answer 31

suction O2 therapy surfactant maintain pt airway

Question 32

ECMO

Answer 32

machine that takes over the lungs to function instead of them

Question 33

ECMO considerations

Answer 33

it is hard on the body, wean off ASAP

Question 34

Complications of Oxygen Therapy

Answer 34

Broncho Pulmonary Dysplasia | Hard to wean off of it after pt gets used to it

Question 35

Retinopathy of Prematurity

Answer 35

eyes injury that may result in blindness; diagnosed only by eye exam

Question 36

Retinopathy Treatment

Answer 36

vitamin E surgery wean off of oxygen

Question 37

Necrotizing Enterocolitis

Answer 37

injury to the intestinal mucosa from hypoxia s&s: blood stool, no feedings tx: surgery, antibiotics

Question 38

Intraventricular Hemorrhage (IVH)

Answer 38

bleeding in ventricles of the brain

Question 39

IVH care

Answer 39

assess for seizures | measure head circumference every 12 hrs

Question 40

Nursing care of preterm infant

Answer 40

skin to skin, kangaroo care, warming bed, warm hands

Question 41

Nutrition for preterm infant

Answer 41

glucose: 45 assess swallow reflexes burp often

Question 42

Gavage feeding

Answer 42

basically NG tube for feeding the infant