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Preterm Labor: Group 6

Preterm labor is defined as labor occurring before 37 weeks of gestation and can affect 9-11% of pregnancies. It is assessed through monitoring for cervical changes, contractions, and fetal heart rate. Management involves bed rest, hydration, infection treatment, corticosteroids for lung maturity, tocolytics to stop contractions, and careful monitoring for signs of preterm delivery.

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Evelyn Medina
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50 views13 pages

Preterm Labor: Group 6

Preterm labor is defined as labor occurring before 37 weeks of gestation and can affect 9-11% of pregnancies. It is assessed through monitoring for cervical changes, contractions, and fetal heart rate. Management involves bed rest, hydration, infection treatment, corticosteroids for lung maturity, tocolytics to stop contractions, and careful monitoring for signs of preterm delivery.

Uploaded by

Evelyn Medina
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PPTX, PDF, TXT or read online on Scribd
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PRETERM LABOR

Group 6
Doneva Medina
Ara Mondelo
Fathma Maruhom
Describe Preterm Labor
• Labor that occurs before the end of week 37 of gestation. It
occurs in approximately 9% to 11% of all pregnancies.

• Any woman having persistent uterine contractions even if they


are mild and widely spaced is considered labor.

• A woman is documented as being in actual labor if


contractions have caused cervical effacement over 80% or
dilation over 1cm.
ASSESSMENT NURSING DIAGNOSIS PLANNING NURSING INTERVENTIONS RATIONALE FOR
INTERVENTIONS
A. ASSESSMENT Risk for injury •   After 8 hours of  Independent:
(MATERNAL & FETAL) nursing • Attach contraction and • Uterine and fetal
  (maternal and interventions: FHR monitors for every monitoring provides
1. Subjective Data fetal) related to a. FHR remains continues evaluation of
“Why am I starting labor so within normal evidence of fetal well-
preterm labor contraction and fetal being.
early?” parameters.
and tocolytic response.  
 
• Persistent, dull and low therapy • Contractions halt  
backache (Silbert-Flagg & after 8 hours of • Institute bed rest with •  Bed rest relieves pressure of
• Vaginal spotting treatment of patient in side-lying the fetus on the cervix. Side-
Pillitteri, 2018) tocolytic. position. lying position enhances
• Feeling of pelvic uterine perfusion.
pressure or abdominal
tightening • Patient will remain
pregnancy at least • Continue maternal and • Decreasing FHR can indicate
• Menstrual like to the point of fetal vital sign fetal distress.
cramping fetal maturity.  
assessment.
• Increased vaginal    
discharge • Instruct patient about • A well-informed patient can
• Uterine contraction preterm labor and about participate more fully in her
• Intestinal cramping steps to be taken to own care.
counteract the process

 
• Help patient to use using • Relaxation techniques help
relaxation techniques, to decrease anxiety and
such as muscle fear, enhancing feelings of
relaxation, breathing and control. Frequent updates
music. Provide frequent about progress help to
updates about progress. minimize fear due to the
unknown.
Allow patient to  
verbalize feelings and
concerns.  
• The presence of a support
person can offer additional
• Contact support person comfort to a patient.
as necessary.  
 
 
• Contact home care nurse • Monitoring to see if
service to provide contractions return can
safely be done at home
monitoring at home. with a conscientious and
well-informed patients.

 
   Collaborative:  
  • Obtain patient •  An ultrasound can
  consent for document fetal health and
ultrasound. Arrange cervical dilation.
for ultrasound to
establish fetal health
and cervical length.
 
• Administer • Betamethasone, asteroid
betamethasone to aid helps to decrease the risk of
fetal lung maturity respiratory distress
and an antibiotic for syndrome in the event of
prematu8re birth. An
urinary tract infection antibiotic decreases urinary
as prescribed. tract infection.

• Administer magnesium •  Magnesium sulfate helps


sulfate as prescribed as an protect preterm babies
IV piggyback with infusion from cerebral palsy.
pump for fetal
neuroprotection.
Continue infusion for 12-
24 hours.
. •  Keep- calcium gluconate •  Calcium gluconate is
available at the bedside. the antidote for
magnesium sulfate
toxicity.
 
 

• Assist with or insert an • Hematocrit, electrolyte


IV line. Begin IV fluid levels, and IV intake
therapy as prescribed. measures the patient’s
fluid volume status.
 
.  

 
1. Objective Data

a. Inspection
• Heart rate: 88 beats/minute
• RR: 22 breaths/min
• BP: 130/78 mmHg
• FHR: 142 beats/min

b. Palpation
• Continued uterine contractions
• Uterine contractions: every 7
minutes lasting 40 seconds
• Cervical effacement: 30%
• Dilation: 2-3 cm

c. Auscultation
• Intermittent auscultation of the
FHR with either a Doppler
ultrasound device or a Pinard
fetal stethoscope

d. Lab/Diagnostic Tests
• Analysis of vaginal mucus
• Transvaginal ultrasound
BOX 21.6 Nursing Care Planning Based on Family Teaching
MEASURE TO HELP PREVENT A RECURRENCE OF PRETERM LABOR FOR WOMEN ON BED REST

Q. Beverly Muzaki has started preterm labor and so id prescribed bed rest on home are. She asks you, “What else can I do to help prevent having

this baby early?’’

A. Although there are no guarantees, several actions can be helpful to prevent a recurrence of preterm labor.

• Remain on bed rest (a lounge or couch) except to use the bathroom.

• Drink 8 to 10 glasses of fluids daily (keep a pitcher by your bed so you do not have to get up).

• Keep mentally active by reading or working on a project to prevent boredom.

• Avoid activities that could stimulate labor, such as nipple stimulation.

• Consult your primary care provider regarding whether sexual relations should be restricted.

• Immediately report signs of ruptured membranes (sudden gush of vaginal fluid) or vaginal bleeding.

• Report signs of urinary tract or vaginal infection (e.g., burning of frequency of urination, vaginal itching or pain).

• Keep appointments for prenatal care.


If uterine contractions recur:

• Empty your bladder to relieve pressure on the uterus.

• Lie down on your left or right side to encourage blood return to the uterus.

• Drink two or three glasses of fluid to increase hydration.

• Contact your healthcare provider to report the incident and ask for further care

measures.
Management for Labor that cannot be Halted
• Caesarean birth may be planned to reduce pressure on the fetal head
and reduce the possibility of subdural or intraventricular hemorrhage
from a vaginal birth, although this is controversial because infants born
by cesarean birth have a higher incidence of respiratory difficulty, which
is already a high risk for a very preterm infant.

• Analgesic agents are administered with caution because an immature


infant will have enough difficulty breathing at birth without the
additional burden of being sedated from a drug such as
meperidine(Demerol).
• External fetal monitor, the monitor screen shows evidence that, although her
infant is going to be small, heart tones seem to be of good quality and the
infant is reacting well to labor.
• Episiotomy is not routinely used because the head of a preterm infant is more
fragile than that of a mature infant, one may be done to relieve excessive
pressure on the head and hopefully reduce the possibility of subdural or
intraventricular hemorrhage.
• The cord of the preterm infant is usually not clamped immediately because
this extra amount of blood help reduce the possibility of preterm anemia and
need for post birth transfusion (Brocato, Holliday,Whitehurst,et al., 2016).
Reference:

Kennedy.(2018)NURSING CARE OF A FAMILY


EXPERIENCING A SUDDEN PREGNANCY
COMPLICATION: PRETERM LABOR (p.542-
546).BM:John Hopkins Medical System

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