MED SURG III EXAM 2026 EXAM PREP STUDY
GUIDE COMPREHENSIVE REVIEW
◉ S/S of PTL. Answer: -presence of uterine contractions
-lower abd. cramping (can stimulate uterus). These are similar to gas
pains
-back pain
-suprapubic pressure
-pelvic pressure
-urinary frqcy.
-CHANGE in vaginal discharge
-rupture of amniotic membranes
◉ Nursing care of PTL. Answer: stop them from doing what they
were doing when it occured.
-bed rest (but this is not a benign intervention) and there is no
evidence to support efficacy.
-treat underlying cause
-tocolytics
,◉ β adrenergic agonist, given PO, only medication approved by FDA
for purpose of uterine contraction cessation. (Serious side effects, no
longer marketed). Answer: Yutopar
◉ β adrenergic agonist, given SQ or PO, promotes relaxation of
smooth muscles. Answer: Terbutaline
◉ Fewer side effects than β adrenergic agonists, promotes relaxation
of smooth muscle, given IV, most commonly used.. Answer:
magnesium sulfate
◉ Antagonist of magnesium sulfate?. Answer: calcium gluconate
◉ Calcium channel blocker - inhibits calcium from entering smooth
muscle. Given PO. Answer: Nifedipine (ends in pine...calcium channel
blockers typically end in pine). AKA procardia.
◉ NSAID that blocks production of prostaglandins (which can cause
c. dilation and effacement). Not recommended after 32 weeks or for
longer than 48 hours. Serious fetal risk (discussed on next card).
Answer: Indomethacin
◉ What serious fetal risk is associated with Indomethacin?. Answer:
Risk for premature closure of the ductus arteriosus increases if the
treatment goes beyond 48 hours or if the gestational age is 32 or
,more weeks. (hence the recommendation of how and when not to
use it).
◉ Once the pregnancy has progressed beyond 34 weeks of gestation,
the benefits of prolonging pregnancy do not justify risk to woman. T
or F?. Answer: T
◉ At first, it was thought that tocolytic therapy could prolong a
threatened pregnancy indefinitely, now research has demonstrated
that a gain of ___hrs to several days is the best outcome if the
womans cervix is 6cm dilated.. Answer: 48 hours
◉ Best reason to use tocolytics?. Answer: They afford the
opportunity to begin administering antenatal glucocorticoids to
accelerate fetal lung maturity.
◉ Antenatal glucocorticoids are given as ___ to the mother to
accelerate fetal lung maturity.. Answer: IM injection.
◉ All women between 24 and 34 weeks of gestation should be given
antenatal glucocorticoids when preterm is a threat. T or F.. Answer:
True
◉ Name of a commonly used glucocorticoid used to accelerate fetal
lung maturity.. Answer: Betamethasone.
, ◉ How many times is betamethasone administered and how long?.
Answer: 12mg,twice, 24 hours apart.
◉ PROM. Answer: Premature rupture of membranes beginning at
least 1 hour before onset of labor at any gestational age.
◉ PPROM. Answer: Preterm Premature rupture of membranes
before 37 weeks of gestation.
◉ two serious side effects of PPROM. Answer: infection and
umbilical cord compression.
◉ Temp should be taken every __ hours when PPROM occurs?.
Answer: 2 hours
◉ A nitrazine or fern test can be used to determine if it was PROM or
vaginal/body discharge...explain what to look for in each test. (KY
jelly may obscure test).. Answer: If amniotic fluid: Nitrazine test -
fluid is tested and paper turns blue indicating a alkaline pH. Fern
test - looks like a fern
◉ Dystocia. Answer: not shoulder dystocia. It is defined as long,
difficult or abnormal labor. It is caused by conditions associated with
GUIDE COMPREHENSIVE REVIEW
◉ S/S of PTL. Answer: -presence of uterine contractions
-lower abd. cramping (can stimulate uterus). These are similar to gas
pains
-back pain
-suprapubic pressure
-pelvic pressure
-urinary frqcy.
-CHANGE in vaginal discharge
-rupture of amniotic membranes
◉ Nursing care of PTL. Answer: stop them from doing what they
were doing when it occured.
-bed rest (but this is not a benign intervention) and there is no
evidence to support efficacy.
-treat underlying cause
-tocolytics
,◉ β adrenergic agonist, given PO, only medication approved by FDA
for purpose of uterine contraction cessation. (Serious side effects, no
longer marketed). Answer: Yutopar
◉ β adrenergic agonist, given SQ or PO, promotes relaxation of
smooth muscles. Answer: Terbutaline
◉ Fewer side effects than β adrenergic agonists, promotes relaxation
of smooth muscle, given IV, most commonly used.. Answer:
magnesium sulfate
◉ Antagonist of magnesium sulfate?. Answer: calcium gluconate
◉ Calcium channel blocker - inhibits calcium from entering smooth
muscle. Given PO. Answer: Nifedipine (ends in pine...calcium channel
blockers typically end in pine). AKA procardia.
◉ NSAID that blocks production of prostaglandins (which can cause
c. dilation and effacement). Not recommended after 32 weeks or for
longer than 48 hours. Serious fetal risk (discussed on next card).
Answer: Indomethacin
◉ What serious fetal risk is associated with Indomethacin?. Answer:
Risk for premature closure of the ductus arteriosus increases if the
treatment goes beyond 48 hours or if the gestational age is 32 or
,more weeks. (hence the recommendation of how and when not to
use it).
◉ Once the pregnancy has progressed beyond 34 weeks of gestation,
the benefits of prolonging pregnancy do not justify risk to woman. T
or F?. Answer: T
◉ At first, it was thought that tocolytic therapy could prolong a
threatened pregnancy indefinitely, now research has demonstrated
that a gain of ___hrs to several days is the best outcome if the
womans cervix is 6cm dilated.. Answer: 48 hours
◉ Best reason to use tocolytics?. Answer: They afford the
opportunity to begin administering antenatal glucocorticoids to
accelerate fetal lung maturity.
◉ Antenatal glucocorticoids are given as ___ to the mother to
accelerate fetal lung maturity.. Answer: IM injection.
◉ All women between 24 and 34 weeks of gestation should be given
antenatal glucocorticoids when preterm is a threat. T or F.. Answer:
True
◉ Name of a commonly used glucocorticoid used to accelerate fetal
lung maturity.. Answer: Betamethasone.
, ◉ How many times is betamethasone administered and how long?.
Answer: 12mg,twice, 24 hours apart.
◉ PROM. Answer: Premature rupture of membranes beginning at
least 1 hour before onset of labor at any gestational age.
◉ PPROM. Answer: Preterm Premature rupture of membranes
before 37 weeks of gestation.
◉ two serious side effects of PPROM. Answer: infection and
umbilical cord compression.
◉ Temp should be taken every __ hours when PPROM occurs?.
Answer: 2 hours
◉ A nitrazine or fern test can be used to determine if it was PROM or
vaginal/body discharge...explain what to look for in each test. (KY
jelly may obscure test).. Answer: If amniotic fluid: Nitrazine test -
fluid is tested and paper turns blue indicating a alkaline pH. Fern
test - looks like a fern
◉ Dystocia. Answer: not shoulder dystocia. It is defined as long,
difficult or abnormal labor. It is caused by conditions associated with
