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Flashcards in Preterm Labor and Infants Deck (51):
1

What is preterm labor?

Any true labor experienced between 20 and 37 weeks

2

What does true labor include?

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

3

What is premature rupture of membranes?

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

4

What is preterm premature rupture of membranes (PrePROM)?

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

5

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

Infection, placental abruption, cord prolapse

6

What are the two most common biochemical markers?

Fetal Fibronectin and Salivary Estriol

7

What is Fetal Fibronectin?

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

8

What is Salivary Estriol?

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

9

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

A shortened length may increase changes of preterm labor.

10

What are risk factors of pre term labor?

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

11

What are signs and symptoms of pre term labor?

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

12

What is the criteria for treatment of pre term labor?

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

13

Management for pre term labor patients

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

14

Management for PrePROM patients

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

15

Management in the hospital for patients

Modified bedrest, hydrate, meds, fetal monitoring

16

What do beta andrengic agents do?

Relax smooth muscle inhibiting uterine activite- Terbutaline (Brethine)

17

What does magnesium sulfate do?

Depresses CNS relaxing smooth muscle in uterus, inhibits contractions

18

What do calcium channel blockers do?

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

19

What do prostaglandin inhibitors do?

Relax smooth muscles including uterus- Indomethacin (indocin)

20

When are glucocorticoids not recommended?

If a cord has prolapsed, chorioamnionitis, abruptio placenta

21

What do glucocordicoids do?

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

22

When are antibiotics given?

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

23

Etiology of preterm birth

Unknown- cervical insuffiency, PPROM, infections

24

What weight is a low birth weight infant?

Under 2500 g

25

What weight is an extremely low birth weight infant?

under 1000 g

26

What age is a preterm infant?

less than 37 weeks

27

What age is a late preterm infant?

34-37 weeks

28

What are characteristics of preterm infants?

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

29

What should you assess in a preterm infant?

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

30

What is Respiratory Distress Syndrome?

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

31

What are signs and symptoms of Respiratory Distress Syndrome?

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

32

How do you manage RDS?

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

33

Nursing Care for RDS

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

34

What is Apnea of Prematurity?

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

35

What is treatment for apnea of prematurity?

caffeine, CPAP, or mechanical ventilation

36

What is Bronchopulmonary Dysplasia (BPD)?

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

37

How do you treat Bronchopulmonary Dysplasia?

PREVENT! Bronchodilator, diuretics, steriods

38

What is Retinopathy of Prematurity (ROP)?

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

39

What is the etiology or cause of ROP?

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

40

How to you treat ROP?

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

41

What is Necrotizing Enterocolitis (NEC)?

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

42

What are risk factors associated with NEC?

Asphyxia, hypoxia, extremely low birth weight

43

What are symptoms of NEC?

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

44

How do you treat NEC?

NPO, suction, antibiotics, colostomy/bowel repair

45

What is Intraventricular Hemorrhage (IVH)?

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

46

What are symptoms of IVH?

Apnea, flaccidity, full fontanel

47

What is the treatment of IVH?

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

48

What should you assess related to nutrition?

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

49

What is gavage feeding?

Feeding into the stomach

50

What should you take into consideration when planning discharge?

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

51

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

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