HACC Nursing 242 Quiz 3 (Final) Questions
With Complete Answers
When does Preterm Labor occur? - ANSWER between 20 and 37 weeks
gestation
What are S&S of Preterm labor? - ANSWER More 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? - ANSWER History 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)? - ANSWER glycoprotein 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? -
ANSWER Assess 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? - ANSWER Advise 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? - ANSWER I - 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 -
ANSWER Mechanism 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 - ANSWER Mechanism 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? - ANSWER Glucocorticoids - Betamethasone
Define Induction - ANSWER is when they start the labor process manually (we
force labor)
, Define Augmentation - ANSWER is 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? - 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? - ANSWER
Bishop Tool
What are the contraindication for Induction? - ANSWER Transverse lie
Umbilical cord prolapse
Previous classical cesarean birth
Active genital herpes
Previous myomectomy entering the endometrial cavity
Contraindication for Augmentations are what? - ANSWER Placenta or vasa
previa
Umbilical cord presentation
Prior classical uterine incision
Active genital herpes
Pelvic structural deformities
Invasive cervical cancer
Define Bishop Score - ANSWER Tool 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? - ANSWER Dilation
Effacement
Station
Consistency of cervix
Cervical position
What is a favorable Bishop Score? - ANSWER 6 or greater
With Complete Answers
When does Preterm Labor occur? - ANSWER between 20 and 37 weeks
gestation
What are S&S of Preterm labor? - ANSWER More 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? - ANSWER History 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)? - ANSWER glycoprotein 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? -
ANSWER Assess 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? - ANSWER Advise 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? - ANSWER I - 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 -
ANSWER Mechanism 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 - ANSWER Mechanism 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? - ANSWER Glucocorticoids - Betamethasone
Define Induction - ANSWER is when they start the labor process manually (we
force labor)
, Define Augmentation - ANSWER is 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? - 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? - ANSWER
Bishop Tool
What are the contraindication for Induction? - ANSWER Transverse lie
Umbilical cord prolapse
Previous classical cesarean birth
Active genital herpes
Previous myomectomy entering the endometrial cavity
Contraindication for Augmentations are what? - ANSWER Placenta or vasa
previa
Umbilical cord presentation
Prior classical uterine incision
Active genital herpes
Pelvic structural deformities
Invasive cervical cancer
Define Bishop Score - ANSWER Tool 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? - ANSWER Dilation
Effacement
Station
Consistency of cervix
Cervical position
What is a favorable Bishop Score? - ANSWER 6 or greater
