Preterm labor-Nursing III-Test 2

Preterm labor is

regular uterine contractions with cervical effacement and dilation prior to 37 weeks

-if not halted, it leads to preterm birth

signs and symptoms of preterm birth

-rhythmic lower abdominal cramping

-complaints of unrelieved backache

-increased vaginal discharge

-downward pelvic pressure

-effacement and dilation of cervix

-persistent uterine contractions (6-8/hr)

-gushing or leaking of fluid

tocolytics

medications to stop the contractions

terbutaline sulfate (brethine)

-can be given SQ or oral

-relaxes smooth muscle of the uterus to stop contractions

-assess for tachycardia, hypotension, tremor, palpitations, chest pain, nervousness, tremors, fetal tachycardia

Nifedipine (procardia) is given:

orally

nifedipine blocks 1______ to inhibit 2_______

1-calcium movement into muscle cells

2-inhibit uterine activity

with nifedipine, we need to asses for ______

hypotension

some side effects of magnesium sulfate include

facial flushing, sweating, visual disturbances, nasal stuffiness, sleepiness

With admin. of magnesium sulfate, we need to observe for signs of toxicity, which can include:

pulmonary edema (crackles in lungs), decreased O2 sats, SOB, absence of deep tendon reflexes, decreased respirations, decreased LOC, decreased urinary output

the antidote for magnesium sulfate toxicity is:

calcium gluconate

magnesium sulfate IV needs to be turned off if respirations are less than:

12

when on magnesium sulfate, patients will need:

-calcium supplements

-strict I&O

-mag checks every 2-4 hours

Betamethasone (steroid) is given:

IM

Betamethasone helps 1______ by 2______

1- promote fetal lung maturity

2-stimulating surfactant production

Betamethasone also ______ in preterm babies less than 34 weeks gestation

prevents/reduces risk of RDS

the 2 doses of betamethasone are given _______ hours apart

24

What are the maternal adverse effects of betamethasone?

-short term: glucose increases, pulmonary edema, infection

-long term: no adverse effects

what are the fetal adverse effects of betamethasone?

no long term effects

Patient education

if experiencing contractions, stop and lie down for one hour on left side

-drink 3-4 glasses of water

-empty bladder

-feel abdomen and time contractions

-call HCP and go to hospital if contractions continue or fluid leaking