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Intrapartum:
Complications of labor and birth
| Question | Answer |
|---|---|
| What is preterm labor? | labor between 20-37 weeks. |
| What does fetal fibronectin test detect? | detects protein in the amniotic fluid that predicts preterm labor. |
| What are nursing interventions to preterm labor? | activity restriction, ensuring hydration, ID and treating infection, administering tocolytic and betamethasone. |
| What do tocolytic medications do? | suppresses contractions (i.e. Terbutaline, Magnesium sulfate, Nifedipine, Indocin). |
| When should tocolytic therapy be immediately D/C? | D/C when pt has s/s of PE: chest pain, SOB, resp. distress |
| Why is betamethasone IM administered? | a glucocorticoid to promote fetal lung maturity and RDS in preterm labor b/2 24-34 wks. |
| What is preterm birth? | birth b/2 20-37 weeks. |
| What is PROM? | ROM 1 hr before onset of true labor. |
| What is PPROM? | ROM between 20-37 weeks. |
| What is the major risk of PROM and PPROM? | Infection for both pt and fetus. Increase risk when ROM is 24+ hr. |
| What is chorioamnionitis? | Infection of the amniotic membranes. |
| What is prolapsed umbilical cord? | When umbilical cord is diplaced, protruding through cervix or preceding presenting part. |
| What are nursing interventions for prolapsed umbilical cord? | call for help, notify MD, position pt hips higher than head, administer O2, FHR monitoring. |
| What is precipitate labor? | Labor lasting 3 hr or less (from onset of contractions to time of birth). |
| What are fetal complications of precipitate labor? | - hypoxia - intracranial hemorrhage |
| What are causes of meconium-stained amniotic fluid? | - normal physio response after 38 wks - umbilical cord compression -> hypoxia: stimulates vagal nerve that increases peristalsis and anal sphincter relaxation. |
| What is postterm pregnancy? | pregnancy 42+ weeks |
| What does postterm pregnancy put neonate at risk for? | asphyixia, meconium aspiration syndrome, dysmaturity syndrome, hypoglycemia, polycythemia, resp distress |
| What is dystocia? | difficult/abnormal labor related to the five Ps (powers, passenger, passageway, positions, pyshce). |
| What are nursing interventions for pt with hypotonic contractions? | - rule out cephalopelvic disproportion - administer oxytocin |
| What are nursing interventions for pt with hypertonic contractions? | give pain meds if Rx, maintain hydration, place in lateral position, provide O2 mask |
| What is shoulder dystocia? | when fetus'shoulder can't pass under materna; symphysis pubis after head delivery. |
| What is amniotic fluid embolism? | rupture of amniotic sac with high intrauterine pressure, causing amniotic fluid and its contents into maternal circulatiom --> obstructs pulmonary vessels |
| How does fetal distress present? | - FHR <110 or >160 - decreased or no variability - fetal blood < 7.2 |
| To facilitate normal labor progress, what position should a nurse help a client get into with a fetus in occiput posterior position? | Hands and knees position |
Created by:
odbal24
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