Preterm Labor and Premature Rupture of Membranes

A woman at 36 weeks' gestation and in preterm labor is being sent home. Which statements about home management would the nurse include in the patient education? Select all that apply.

"Avoid sex during this time." The woman experiencing preterm labor should avoid sexual intercourse and orgasm, both of which could speed labor. "Only move around your house when necessary." The nurse would advise the woman experiencing preterm labor to restrict her activity. "Notify the health care provider if your temperature is greater than 100° F." The woman experiencing preterm labor should be taught to take her temperature at least four times a day and report temperatures greater than 100° F to the health care provider, as a fever may indicate infection.

A 38-year-old nulliparous woman bearing twins asks the nurse why she is at risk for PROM. Which statement by the nurse is appropriate?

"Bearing multiple fetuses in one pregnancy can lead to overdistention of the uterus, which could result in PROM." Overdistention of the uterus can be caused by multiple fetuses and may be a factor in an increased risk for PROM.

A woman is admitted to the Labor and Delivery unit with premature rupture of membranes at 31 weeks' gestation and is experiencing symptoms of preterm labor. The nurse has assessed the woman for signs of infection and is administering corticosteroids following an order from the health care provider. Which statement should the nurse make to explain why corticosteroids have been ordered?

"Corticosteroids are administered to help speed your baby's lung maturity." The nurse should make this statement, as corticosteroids are administered to speed fetal lung maturity.

Which statement does the nurse use to describe PROM or PPROM to the pregnant woman?

"PROM could occur at 38 weeks." Describing PROM as occurring before the onset of true labor is an appropriate response.

The nurse administered magnesium sulfate to a woman experiencing preterm labor following a health care provider order. Which assessment would concern the nurse?

10 respirations per minute The nurse assesses the woman who has been administered magnesium sulfate for respirations. Ten respirations per minute is a common hospital criteria to discontinue magnesium sulfate therapy.

A woman at 34 weeks' gestation presents with painful uterine contractions, lower back pain, and bloody vaginal discharge. Additionally, the woman has a temperature of 102° F and is noted to be at 2 cm dilated. Which action should the nurse take first?

Place the woman on bed rest. Placing the woman on bed rest in side-lying position is the initial nursing intervention that is appropriate in preterm labor. This action helps prevent further uterine contractions.

Which pregnant women are at risk for PPROM? Select all that apply.

A woman who is bearing twins Bearing twins can result in overdistention of the uterus; this is a possible cause of PROM. A woman who is depressed over losing her job A pregnant woman who is depressed over losing her job is experiencing maternal stress, which is recognized as a possible cause of PROM. A woman with a Gardnerella vaginalis infection Gardnerella vaginalis infections predispose pregnant women to PROM.

A woman in preterm labor is receiving intravenous magnesium sulfate. Which are the nurse's priority assessments? Select all that apply.

Assess respirations Assessing for at least 12 respirations per minute is a priority for this woman because an adverse effect of magnesium sulfate is respiratory paralysis. Monitor urine output Assessing that the woman's urine output is at least 30 mL/hr is a priority in caring for this woman, because urinary output will serve as determinant factor whether treatment will be continued or terminated by the provider. Assess for deep tendon reflexes Assessing for the presence of deep tendon reflexes is a priority in caring for this woman because depressed or absent reflexes is indicative of early magnesium intoxication.

A woman who is at 36 weeks' gestation thinks she is experiencing labor. Which signs or symptoms would support the woman's suspicion?

Menstrual-like cramps Menstrual-like cramps are a sign of preterm labor, which may be related to premature uterine contractions Reports of pelvic pressure Pelvic pressure is a symptom of preterm labor, and may also be related to premature uterine contractions Reports that the baby is "balling up" A sensation that the baby is frequently "balling up" is a symptom of preterm labor

Match the woman to the relevant high-risk condition.

PTL A woman at 28 weeks who is having regular uterine contractions. PROM A woman at 38 weeks whose amniotic membranes have ruptured, but she has not experienced any contractions. PPROM A woman at 32 weeks whose amniotic membranes have ruptured. Chorioamnionitis A woman at 33 weeks who has a temperature of 101.5 degrees F and abdominal tenderness.

A woman at 34 weeks' gestation reports having four contractions in one hour and menstrual-like abdominal cramps. Which condition is the woman experiencing?

Preterm labor (PTL) A woman with four uterine contractions in one hour and menstrual-like abdominal cramps indicates PTL. PTL occurs when regular contractions begin to open a pregnant woman's cervix before 37 weeks.

A pregnant woman is admitted to labor and delivery unit after reports of preterm contractions. Which action is a priority for the nurse to take?

Restrict the woman's activity Activity restriction reduces uterine contractions and it is an appropriate priority nursing action at this stage as the nurse focuses on initial measures to delay preterm labor, such as reducing the woman's activity.