ATI maternal newborn OB Final Exam
Question Review- Chapter 7 Anatomy
and Physiology of Pregnancy , Anatomy
& Physiology of Pregnancy, OB
Chapters 8-9, Care (chapter 9), OB
Chapter 10: Assessment of High Risk
Pregnancy
Early Onset of Labor - ANS Preterm labor, premature rupture of membranes, and preterm premature
rupture of membranes
Preterm labor - ANS uterine contractions and cervical changes that occur between 20 and 37 weeks of
gestation.
Name 5 risk factors that are associated with preterm labor: - ANS ● Infections of the urinary tract,
vagina, or chorioamnionitis (infection of the amniotic sac)
● Previous preterm birth
● Multifetal pregnancy
● Hydramnios (excessive amniotic fluid)
● Age below 17 or above 35
Name another 5 risk factors associated with preterm labor: - ANS ● Low socioeconomic status
● Smoking
● Substance use
● Domestic violence
● History of multiple miscarriages or abortions
,Name an additional 7 risk factors associated with preterm labor: - ANS ● Diabetes mellitus or
hypertension
● Lack of prenatal care
● Recurrent premature dilation of the cervix
● Placenta previa or abruptio placentae
● Preterm premature rupture of membranes
● Short interval between pregnancies
● Uterine abnormalities
What kind of subjective assessment data can be observed with preterm labor? - ANS ◯ Persistent low
backache
◯ Pressure in the pelvis and cramping
◯ Gastrointestinal cramping, sometimes with diarrhea
◯ Urinary frequency
◯ Vaginal discharge
What kind of objective assessment data would be observed with preterm labor? - ANS ■ Increase,
change, or blood in vaginal discharge
■ Change in cervical dilation
■ Regular uterine contractions with a frequency of every 10 min or greater, lasting 1 hr or longer
■ Premature rupture of membranes
What laboratory tests are associated with preterm labor? - ANS ■ Fetal fibronectin
■ Cervical cultures
■ CBC
■ Urinalysis
,What are the common diagnostic procedures for a woman at risk for preterm labor? - ANS Fetal
fibronectin swab
Ultrasound
HUAM
Cervical Cultures
Biophysical profile
Explain the significance of the following diagnostic procedures to preterm labor:
Fetal fibronectin swab
Ultrasound - ANS ■ Obtain swab of vaginal secretions for fetal fibronectin between 24 and 34 weeks of
gestation. This protein can be found in the vaginal secretions when the fetal membrane integrity is lost.
This test is used to determine preterm labor.
■ Measure endocervical length with an ultrasound to assess for a shortened cervix, which is suggested in
certain studies to precede preterm labor.
Explain the significance of the following diagnostic procedures to preterm labor:
HUAM
Cervical Cultures
Biophysical profile - ANS ■ Use home uterine activity monitoring (HUAM), which is a uterine contraction
monitor that can be used by the client at home. HUAM is not considered to be effective in preventing
preterm labor.
■ Obtain cervical cultures to detect if there is a presence of infectious organisms. Culture and sensitivity
results guide prescription of an appropriate antibiotic, if indicated.
, ■ Perform a biophysical profile and/or a nonstress test to provide information about the fetal well-
being.
What is the main nursing care objective in the management of preterm labor? - ANS stopping uterine
contractions
What nursing care actions would the nurse implement when managing preterm labor? - ANS ■ Activity
restriction
■ Ensuring hydration
■ Identifying and treating an infection
■ Chorioamnionitis should be suspected with the occurrence of elevated temperature and tachycardia.
■ Monitor FHR and contraction pattern.
Explain the significance of advising a woman to restrict activity for the management of preterm labor: -
ANS ■ Activity restriction
☐ Instruct the client on ways to modify her environment to allow for modified bed rest, yet have the
ability to fulfill role responsibilities. Strict bed rest has been found to have adverse effects.
☐ Encourage the client to rest in the left lateral position to increase blood flow to the uterus and
decrease uterine activity.
☐ Tell the client to avoid sexual intercourse.
Why is it important to ensure that a woman facing preterm is adequately hydrated? - ANS Dehydration
stimulates the pituitary gland to secrete an antidiuretic hormone and oxytocin. Preventing dehydration
prevents the release of oxytocin, which stimulates uterine contractions.
When managing preterm labor, why is it important to monitor FHR and contraction pattern? - ANS Fetal
tachycardia, a prolonged increase in the FHR greater than 160/min may indicate infection, which is
frequently associated with preterm labor.
Question Review- Chapter 7 Anatomy
and Physiology of Pregnancy , Anatomy
& Physiology of Pregnancy, OB
Chapters 8-9, Care (chapter 9), OB
Chapter 10: Assessment of High Risk
Pregnancy
Early Onset of Labor - ANS Preterm labor, premature rupture of membranes, and preterm premature
rupture of membranes
Preterm labor - ANS uterine contractions and cervical changes that occur between 20 and 37 weeks of
gestation.
Name 5 risk factors that are associated with preterm labor: - ANS ● Infections of the urinary tract,
vagina, or chorioamnionitis (infection of the amniotic sac)
● Previous preterm birth
● Multifetal pregnancy
● Hydramnios (excessive amniotic fluid)
● Age below 17 or above 35
Name another 5 risk factors associated with preterm labor: - ANS ● Low socioeconomic status
● Smoking
● Substance use
● Domestic violence
● History of multiple miscarriages or abortions
,Name an additional 7 risk factors associated with preterm labor: - ANS ● Diabetes mellitus or
hypertension
● Lack of prenatal care
● Recurrent premature dilation of the cervix
● Placenta previa or abruptio placentae
● Preterm premature rupture of membranes
● Short interval between pregnancies
● Uterine abnormalities
What kind of subjective assessment data can be observed with preterm labor? - ANS ◯ Persistent low
backache
◯ Pressure in the pelvis and cramping
◯ Gastrointestinal cramping, sometimes with diarrhea
◯ Urinary frequency
◯ Vaginal discharge
What kind of objective assessment data would be observed with preterm labor? - ANS ■ Increase,
change, or blood in vaginal discharge
■ Change in cervical dilation
■ Regular uterine contractions with a frequency of every 10 min or greater, lasting 1 hr or longer
■ Premature rupture of membranes
What laboratory tests are associated with preterm labor? - ANS ■ Fetal fibronectin
■ Cervical cultures
■ CBC
■ Urinalysis
,What are the common diagnostic procedures for a woman at risk for preterm labor? - ANS Fetal
fibronectin swab
Ultrasound
HUAM
Cervical Cultures
Biophysical profile
Explain the significance of the following diagnostic procedures to preterm labor:
Fetal fibronectin swab
Ultrasound - ANS ■ Obtain swab of vaginal secretions for fetal fibronectin between 24 and 34 weeks of
gestation. This protein can be found in the vaginal secretions when the fetal membrane integrity is lost.
This test is used to determine preterm labor.
■ Measure endocervical length with an ultrasound to assess for a shortened cervix, which is suggested in
certain studies to precede preterm labor.
Explain the significance of the following diagnostic procedures to preterm labor:
HUAM
Cervical Cultures
Biophysical profile - ANS ■ Use home uterine activity monitoring (HUAM), which is a uterine contraction
monitor that can be used by the client at home. HUAM is not considered to be effective in preventing
preterm labor.
■ Obtain cervical cultures to detect if there is a presence of infectious organisms. Culture and sensitivity
results guide prescription of an appropriate antibiotic, if indicated.
, ■ Perform a biophysical profile and/or a nonstress test to provide information about the fetal well-
being.
What is the main nursing care objective in the management of preterm labor? - ANS stopping uterine
contractions
What nursing care actions would the nurse implement when managing preterm labor? - ANS ■ Activity
restriction
■ Ensuring hydration
■ Identifying and treating an infection
■ Chorioamnionitis should be suspected with the occurrence of elevated temperature and tachycardia.
■ Monitor FHR and contraction pattern.
Explain the significance of advising a woman to restrict activity for the management of preterm labor: -
ANS ■ Activity restriction
☐ Instruct the client on ways to modify her environment to allow for modified bed rest, yet have the
ability to fulfill role responsibilities. Strict bed rest has been found to have adverse effects.
☐ Encourage the client to rest in the left lateral position to increase blood flow to the uterus and
decrease uterine activity.
☐ Tell the client to avoid sexual intercourse.
Why is it important to ensure that a woman facing preterm is adequately hydrated? - ANS Dehydration
stimulates the pituitary gland to secrete an antidiuretic hormone and oxytocin. Preventing dehydration
prevents the release of oxytocin, which stimulates uterine contractions.
When managing preterm labor, why is it important to monitor FHR and contraction pattern? - ANS Fetal
tachycardia, a prolonged increase in the FHR greater than 160/min may indicate infection, which is
frequently associated with preterm labor.
