PPN 301 -Week 5: Labor at Risk, 4th
Trimester and Early Postpartum Study
Guide Questions All Solved (Graded A+)
Preterm Labor - Answer cervical changes with uterine contraction occurring between 20-37
Rate is higher among patients younger than 18 years of age or older than 35 years
Preterm Birth - Answer Any birth occurring before 37 weeks completion of pregnancy
regardless of the weight of the infant
Causes of Preterm Labor - Answer Infections
Vaginal bleeding
Hormone changes
Stretching of the uterus.
Signs and Symptoms of Preterm labour
Uterine Activity - Answer Uterine contractions more frequent than every 10 minutes,
persisting for 1 hour or more
Uterine contractions painful or painless
Signs and Symptoms of Preterm labour
Discomfort - Answer Lower abdominal cramping similar to gas pains; may be accompanied by
diarrhea
Dull, intermittent low back pain (below the waist)
Painful, menstrual-like cramps
Suprapubic pain or pressure
Pelvic pressure or heaviness; feeling that "baby is pushing down"
Urinary frequency
Signs and Symptoms of Preterm labour
Vaginal Discharge - Answer Change in character and amount of usual discharge: thicker
(mucoid) or thinner (watery), bloody, brown or colourless, increased amount, odour
Predicting preterm labour and birth
Fetal fibronectin test (FFN)
Cervical length <30mm are risk preterm labour
Combination of both is better
,Suppression of uterine activity
Tocolytics -used suppress labour -(no specific medication approved in Canada)
Nifedipine, indomethacin, magnesium sulphate - Answer Tocolytics -used suppress labour -(no
specific medication approved in Canada)
Nifedipine, indomethacin, magnesium sulphate
Early recognition and diagnosis is based on three major diagnostic criteria: - Answer 1.
Gestational age between 20 and 36 6/7 weeks
2. Regular uterine activity, accompanied by a cervical change
3. Initial presentation with regular contractions and cervical dilation of 2 cm or greater
Contraindications of Tocolytics
Maternal - Answer Severe pre-eclampsia or severe gestational hypertension
Significant vaginal bleeding
Intrauterine infection (chorioamnionitis)
Cardiac disease
Medical or obstetrical condition that contraindicates continuation of pregnancy
Contraindications of Tocolytics
fetal - Answer Gestational age of 37 weeks or more
Fetal demise
Lethal fetal anomaly
Evidence of acute or chronic fetal compromise
Promotion of fetal lung maturity - Answer Antenatal glucocorticoids
to accelerate fetal lung maturity by stimulating fetal surfactant production.
Management of inevitable preterm birth - Answer magnesium sulphate may be administered
to reduce or prevent newborn neurological morbidity
Nursing Care for a Patient Receiving Tocolytic Therapy - Answer position patient in lateral
position to enhance placental perfusion and reduce pressure on the cervix.
Monitor vital signs, including lung sounds and respiratory effort, fetal heart rate and pattern,
and labour status according to hospital protocol and professional standards.
, Assess labouring patient and fetus for signs of adverse reactions related to the tocolytic
medication(s) being administered (see Medication Guide: Tocolytic Therapy for Preterm
Labour).
Determine labouring patient's fluid balance by measuring intake and output.
Provide psychosocial support to the patient and their family as well as opportunities for them to
express feelings and concerns.
Education on early prererm labour signs and actions - Answer Stop what you are doing.
Empty your bladder.
Drink two to three glasses of water or juice.
Lie down on your side for 1 hour.
Palpate for contractions.
If symptoms continue, call your health care provider or go to the hospital.
If symptoms go away, resume light activity but not what you were doing when the symptoms
began.
If symptoms return, call your health care provider or go to the hospital.
If any of the following symptoms occur, call your health care provider or go to the hospital
immediately:
Uterine contractions every 10 minutes or less for 1 hour or more
Vaginal bleeding
Fluid leaking from the vagina
Preterm Premature rupture Of Membranes RPROM - Answer -Is the spontaneous rupture of
the amniotic sac and leakage of amniotic fluid beginning before the onset of labour at any
gestational age.
preterm PROM or pPROM)-is the rupture of membranes before the completion of 37 weeks of
gestation)
Nursing Interventions of PROM - Answer Inform patient to count fetal movements daily,
because a slowing of fetal movement is a precursor to severe fetal compromise.
Patients should feel six movements in 2 hours; if they do not, further antenatal testing (NST,
BPP, or both) is required
Monitor and educate signs of infection is a major part of nursing care and patient education
after preterm PROM
ever, foul-smelling vaginal discharge, maternal and fetal tachycardia) should be reported
immediately to the primary health care provide
Maternal Complications with PROM - Answer Chorioamnionitis-bacterial infection of the
amniotic cavity
Trimester and Early Postpartum Study
Guide Questions All Solved (Graded A+)
Preterm Labor - Answer cervical changes with uterine contraction occurring between 20-37
Rate is higher among patients younger than 18 years of age or older than 35 years
Preterm Birth - Answer Any birth occurring before 37 weeks completion of pregnancy
regardless of the weight of the infant
Causes of Preterm Labor - Answer Infections
Vaginal bleeding
Hormone changes
Stretching of the uterus.
Signs and Symptoms of Preterm labour
Uterine Activity - Answer Uterine contractions more frequent than every 10 minutes,
persisting for 1 hour or more
Uterine contractions painful or painless
Signs and Symptoms of Preterm labour
Discomfort - Answer Lower abdominal cramping similar to gas pains; may be accompanied by
diarrhea
Dull, intermittent low back pain (below the waist)
Painful, menstrual-like cramps
Suprapubic pain or pressure
Pelvic pressure or heaviness; feeling that "baby is pushing down"
Urinary frequency
Signs and Symptoms of Preterm labour
Vaginal Discharge - Answer Change in character and amount of usual discharge: thicker
(mucoid) or thinner (watery), bloody, brown or colourless, increased amount, odour
Predicting preterm labour and birth
Fetal fibronectin test (FFN)
Cervical length <30mm are risk preterm labour
Combination of both is better
,Suppression of uterine activity
Tocolytics -used suppress labour -(no specific medication approved in Canada)
Nifedipine, indomethacin, magnesium sulphate - Answer Tocolytics -used suppress labour -(no
specific medication approved in Canada)
Nifedipine, indomethacin, magnesium sulphate
Early recognition and diagnosis is based on three major diagnostic criteria: - Answer 1.
Gestational age between 20 and 36 6/7 weeks
2. Regular uterine activity, accompanied by a cervical change
3. Initial presentation with regular contractions and cervical dilation of 2 cm or greater
Contraindications of Tocolytics
Maternal - Answer Severe pre-eclampsia or severe gestational hypertension
Significant vaginal bleeding
Intrauterine infection (chorioamnionitis)
Cardiac disease
Medical or obstetrical condition that contraindicates continuation of pregnancy
Contraindications of Tocolytics
fetal - Answer Gestational age of 37 weeks or more
Fetal demise
Lethal fetal anomaly
Evidence of acute or chronic fetal compromise
Promotion of fetal lung maturity - Answer Antenatal glucocorticoids
to accelerate fetal lung maturity by stimulating fetal surfactant production.
Management of inevitable preterm birth - Answer magnesium sulphate may be administered
to reduce or prevent newborn neurological morbidity
Nursing Care for a Patient Receiving Tocolytic Therapy - Answer position patient in lateral
position to enhance placental perfusion and reduce pressure on the cervix.
Monitor vital signs, including lung sounds and respiratory effort, fetal heart rate and pattern,
and labour status according to hospital protocol and professional standards.
, Assess labouring patient and fetus for signs of adverse reactions related to the tocolytic
medication(s) being administered (see Medication Guide: Tocolytic Therapy for Preterm
Labour).
Determine labouring patient's fluid balance by measuring intake and output.
Provide psychosocial support to the patient and their family as well as opportunities for them to
express feelings and concerns.
Education on early prererm labour signs and actions - Answer Stop what you are doing.
Empty your bladder.
Drink two to three glasses of water or juice.
Lie down on your side for 1 hour.
Palpate for contractions.
If symptoms continue, call your health care provider or go to the hospital.
If symptoms go away, resume light activity but not what you were doing when the symptoms
began.
If symptoms return, call your health care provider or go to the hospital.
If any of the following symptoms occur, call your health care provider or go to the hospital
immediately:
Uterine contractions every 10 minutes or less for 1 hour or more
Vaginal bleeding
Fluid leaking from the vagina
Preterm Premature rupture Of Membranes RPROM - Answer -Is the spontaneous rupture of
the amniotic sac and leakage of amniotic fluid beginning before the onset of labour at any
gestational age.
preterm PROM or pPROM)-is the rupture of membranes before the completion of 37 weeks of
gestation)
Nursing Interventions of PROM - Answer Inform patient to count fetal movements daily,
because a slowing of fetal movement is a precursor to severe fetal compromise.
Patients should feel six movements in 2 hours; if they do not, further antenatal testing (NST,
BPP, or both) is required
Monitor and educate signs of infection is a major part of nursing care and patient education
after preterm PROM
ever, foul-smelling vaginal discharge, maternal and fetal tachycardia) should be reported
immediately to the primary health care provide
Maternal Complications with PROM - Answer Chorioamnionitis-bacterial infection of the
amniotic cavity
