Complete Study Guide & Practice Questions
When does Preterm Labor occur? - correct answerbetween 20 and 37 weeks gestation
What are S&S of Preterm labor? - correct answerMore than 6 uterine contractions in
one hour
Documented cervical change
>1cm or cervical effacement of 80% or >
Low, dull backache
Pelvic pressure
Change in vaginal discharge
What are the Risk factors for Preterm Labor? - correct answerHistory of Preterm birth
Infection
Smoking, alcohol, and illicit drugs
Lower education and socioeconomic status
African American race
Obesity
Hypertension
Diabetes
What is fetal fibronectin (fFN)? - correct answerglycoprotein found in fetal membranes
and decidua, the glue that holds the membranes to the decidua
What are the Nurses' actions when assessing for S&S of Preterm Labor? - correct
answerAssess for signs of preterm labor
Monitor FHR and UC
Obtain vaginal and urine cultures as ordered
Obtain fFN
Provide oral and IV hydration
Administer tocolytics as ordered
Administer glucocorticoids
Position patient on side
Provide emotional support
Provide education concerning treatment plan
Monitor response to treatment
What are some teaching points to a mother who has been recently been advised of
being at risk of a preterm labor? - correct answerAdvise what the S&S are for Preterm
labor
No heavy lifting
No long travel
,Minimize standing
PELVIC REST
No breast stimulation
What are the 4 main Tocolytics what do they do? - correct answerI - Indomethecin
(NSAID)
N - Nifedipine (CA Channel Blocker)
M - Magnesium Sulfate
T - Terbutaune (Adrenergic Agonist)
Tocolytic - Brethine (Terbutaline) 10 mcg/min starting off max dose 80 mcg/min - correct
answerMechanism of Action: Beta2-adrenergic agonist
SQ injection in lateral deltoid area
Adverse reactions: nervousness. / Restlessness. /. tremor. /. Headache. / Insomnia. /
Pulmonary Edema. / angina / arrhythmias / HTN / Tachycardia. / Myocardial Ischemia. /.
n/v. / Hyperglycemia. / Hypokalemia
Monitor:
Maternal. /. Fetal. /. Labor
* don't use with Beta blockers
*taper dose in 5 mcg after 30-60 mins of contraction-free period
Tocolytic - Magnesium Sulfate - correct answerMechanism of action: Mineral /
electrolyte
Adverse reaction: drowsiness, decreased RR, Diarrhea, flushing, sweating,
Hypothermia, bradycardia, hypotension, arrhythmias
Monitor
Maternal
Fetal
Labor: only use for a max of 5-7 days of preterm labor
Antidote: Calcium Gluconate
What medication can be given to help improve lung function in a fetus that is about to
be born? - correct answerGlucocorticoids - Betamethasone
Define Induction - correct answeris when they start the labor process manually (we
force labor)
Define Augmentation - correct answeris when she goes into labor but then stops or
slows down
What are the interventions that you should do as a nurse for a patient who is going to
have induction? - correct answer- SVE (Sterile Vaginal Exam) - Done to see how far
she is along in her labor
- Check Contractions - putting the baby on the fetal heart monitor allows us monitor the
child and ensure that the child isn't in distress
, - Check her vital Signs - make sure she doesn't have HTN / Hypovolemia
- Place an IV - a secure feature to stop contraction if they are overestimating the child
Collect Labs - for CBC Hgb, and Hct, look for infection, Plt counts
Type and Cross for Blood transfusion if needed
Need to know platets b4 and epidural because of risk of bleeding
What evaluation tool is used to decide if induction is favorable? - correct answerBishop
Tool
What are the contraindication for Induction? - correct answerTransverse lie
Umbilical cord prolapse
Previous classical cesarean birth
Active genital herpes
Previous myomectomy entering the endometrial cavity
Contraindication for Augmentations are what? - correct answerPlacenta or vasa previa
Umbilical cord presentation
Prior classical uterine incision
Active genital herpes
Pelvic structural deformities
Invasive cervical cancer
Define Bishop Score - correct answerTool used to determine cervical ripeness in order
to choose appropriate intervention for induction
A number is assigned for each assessment and then totaled
A score of 6 or more is considered favorable for induction
What does the Bishop Score Assess? - correct answerDilation
Effacement
Station
Consistency of cervix
Cervical position
What is a favorable Bishop Score? - correct answer6 or greater
List the various scoring options for each assessment - correct answerScore is 0 - 3 :
must add each up for each assessment
Dilation 0 | 1-2 cm | 3-4 cm| 5-6 cm
Effacement 0-30% | 40 -50% | 60- 70% | 80%
Station -3 | -2 | -1/0 | +1/+2
Consistency of Cervix Firm | Medium | Soft (highest score is a 2)
Cervical Position. Posterior | Medium | Anterior (highest score is a 2)
What are some nursing actions that are required prior to preforming a cervical
Ripening? - correct answerMaternal Status - vital signs, underlying conditions, SVE,
uterine contractions, obtain consent, IV access, ensure pt. voids