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Intrapartum:

Complications of labor and birth

QuestionAnswer
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