PPN 301: WEEK 5 - Labour At Risk, 4th
Trimester & Early Postpartum UPDATED
ACTUAL Exam Questions and CORRECT
Answers
preterm labour - CORRECT ANSWER - cervical changes with uterine contraction
occurring between 20-37 weeks
- rate is HIGHER among patients younger than 18 or older than 35
preterm birth - CORRECT ANSWER - any birth occurring at less than 37 weeks
completion of pregnancy
risk factors for preterm labour - CORRECT ANSWER - - hx of previous spontaneous
preterm birth (btn 20 & 36 weeks of gestation)
- African descent
genital tract infection
- low prepregnancy weight
- low socioeconomic status
- use of assisted human reproduction
causes of preterm labor - CORRECT ANSWER - - infections
- vaginal bleeding
hormone changes
- stretching of the uterus
signs and symptoms of preterm labour - CORRECT ANSWER - 1) uterine activity
- uterine contractions more frequent than every 10 minutes, persisting for 1 hour or more; are
painful or painless
,2) discomfort
- lower abdominal cramps similar to gas pain, dull back pain, pelvic pressure, urinary frequency
3) vaginal discharge
- change in character and amount of usual discharge: thicker (mucoid) or thinner (watery),
bloody, brown or colourless, increased amount, odour
predicting preterm labour & birth - CORRECT ANSWER - fetal fibronectin test (FFN)
and/or cervical length <30mm is risk preterm labour
early recognition and diagnosis of preterm labour/birth are based on three major diagnostic
criteria: - CORRECT ANSWER - 1) gestational age between 20 and 36 weeks and 6/7
days
2) regular uterine activity accompanied by a cervical change
3) initial presentation with regular contractions and cervical dilation of 2cm or greater
nursing care for preterm labour/birth - CORRECT ANSWER - prevention - preconception
counselling
- addressing of risk factors and health promotion activities in the prenatal stage
- administration of prophylactic progesterone daily vaginal suppositories or creams and weekly
intramuscular injections to decrease the rate of preterm labour and birth
interdisciplinary care - suppression of uterine activity - CORRECT ANSWER - tocolytics
- used to suppress labour (no specific medications approved in Canada)
, e.g., nifedipine, indomethacin, magnesium sulphate
contraindications of tocolytics - CORRECT ANSWER - Maternal
1. Severe Preeclampsia
2. Eclampsia
3. Bleeding with hemodynamic instability
4. Contraindications to specific medications
Fetal
1. Intrauterine fetal demise
2. Lethal fetal anomaly
3. Non-reassuring fetal status
4. Chorioamnionitis (inflammation of membranes)
5. PPROM
management of inevitable preterm birth - CORRECT ANSWER - magnesium sulphate
may be administered to reduce or prevent newborn neurological morbidity
cervical cerclage - CORRECT ANSWER - A surgical procedure in which the cervix is
sewn closed during pregnancy to prevent premature birth due to weak cervix
nursing care for tocolytic therapy - CORRECT ANSWER - - explain the purpose and
adverse effects of the tocolytic medication(s) ordered for the patient and their family
- position the patient in a lateral position to enhance placental perfusion and reduce pressure on
the cervix
- monitor vitals, lung sounds, respiratory effort, fetal heart rate & pattern, and labour status
(varies depending on hospital protocol & professional standards)
Trimester & Early Postpartum UPDATED
ACTUAL Exam Questions and CORRECT
Answers
preterm labour - CORRECT ANSWER - cervical changes with uterine contraction
occurring between 20-37 weeks
- rate is HIGHER among patients younger than 18 or older than 35
preterm birth - CORRECT ANSWER - any birth occurring at less than 37 weeks
completion of pregnancy
risk factors for preterm labour - CORRECT ANSWER - - hx of previous spontaneous
preterm birth (btn 20 & 36 weeks of gestation)
- African descent
genital tract infection
- low prepregnancy weight
- low socioeconomic status
- use of assisted human reproduction
causes of preterm labor - CORRECT ANSWER - - infections
- vaginal bleeding
hormone changes
- stretching of the uterus
signs and symptoms of preterm labour - CORRECT ANSWER - 1) uterine activity
- uterine contractions more frequent than every 10 minutes, persisting for 1 hour or more; are
painful or painless
,2) discomfort
- lower abdominal cramps similar to gas pain, dull back pain, pelvic pressure, urinary frequency
3) vaginal discharge
- change in character and amount of usual discharge: thicker (mucoid) or thinner (watery),
bloody, brown or colourless, increased amount, odour
predicting preterm labour & birth - CORRECT ANSWER - fetal fibronectin test (FFN)
and/or cervical length <30mm is risk preterm labour
early recognition and diagnosis of preterm labour/birth are based on three major diagnostic
criteria: - CORRECT ANSWER - 1) gestational age between 20 and 36 weeks and 6/7
days
2) regular uterine activity accompanied by a cervical change
3) initial presentation with regular contractions and cervical dilation of 2cm or greater
nursing care for preterm labour/birth - CORRECT ANSWER - prevention - preconception
counselling
- addressing of risk factors and health promotion activities in the prenatal stage
- administration of prophylactic progesterone daily vaginal suppositories or creams and weekly
intramuscular injections to decrease the rate of preterm labour and birth
interdisciplinary care - suppression of uterine activity - CORRECT ANSWER - tocolytics
- used to suppress labour (no specific medications approved in Canada)
, e.g., nifedipine, indomethacin, magnesium sulphate
contraindications of tocolytics - CORRECT ANSWER - Maternal
1. Severe Preeclampsia
2. Eclampsia
3. Bleeding with hemodynamic instability
4. Contraindications to specific medications
Fetal
1. Intrauterine fetal demise
2. Lethal fetal anomaly
3. Non-reassuring fetal status
4. Chorioamnionitis (inflammation of membranes)
5. PPROM
management of inevitable preterm birth - CORRECT ANSWER - magnesium sulphate
may be administered to reduce or prevent newborn neurological morbidity
cervical cerclage - CORRECT ANSWER - A surgical procedure in which the cervix is
sewn closed during pregnancy to prevent premature birth due to weak cervix
nursing care for tocolytic therapy - CORRECT ANSWER - - explain the purpose and
adverse effects of the tocolytic medication(s) ordered for the patient and their family
- position the patient in a lateral position to enhance placental perfusion and reduce pressure on
the cervix
- monitor vitals, lung sounds, respiratory effort, fetal heart rate & pattern, and labour status
(varies depending on hospital protocol & professional standards)
