Sem 3 - Unit 5 - Premature Delivery - NCO

A nurse is caring for a client in preterm labor who is receiving a course of corticosteroids to promote fetal lung maturity. What test may be used to most accurately determine fetal lung maturity? 1 Amniocentesis 2 Ultrasonography 3 Radioreceptor assay 4 Chorionic villus sampling

1 Amniocentesis The presence of phosphatidylglycerol and a 2:1 lecithin/sphingomyelin ratio in the amniotic fluid confirm fetal lung maturity. Ultrasonography cannot be used to determine fetal lung maturity. The radioreceptor assay is a test used to determine whether the client is pregnant; it is done very early in pregnancy. Chorionic villus sampling, a diagnostic screening test, is done between the eighth and twelfth weeks of pregnancy to determine fetal chromosomal status.

Which drug is used to prevent preterm labor? 1 Oxytocin 2 Nifedipine 3 Raloxifene 4 Clomiphene

2 Nifedipine Nifedipine is used to prevent preterm labor because it inhibits myometrial activity by blocking the influx of calcium. Oxytocin may be used to induce labor. Raloxifene is used to prevent postmenopausal osteoporosis. Clomiphene is used to cause ovulation.

A tocolytic was administered to a woman to inhibit labor and maintain pregnancy. Which nursing interventions would be beneficial to this client? Select all that apply. 1 The drug should not be administered on a long term basis. 2 The drug should be continued after the contractions subside. 3 The client's vital signs and fetal heart rate should be monitored regularly. 4 The dose and route of administration should be determined. 5 The client should be placed in the right lateral recumbent position.

1 The drug should not be administered on a long term basis. 3 The client's vital signs and fetal heart rate should be monitored regularly. 4 The dose and route of administration should be determined. Long-term use of tocolytics may cause birth defects; therefore, tocolytics should not be administered on a long-term basis. The vital signs and fetal heart rate should be monitored regularly and closely to detect any abnormalities. The dose and route of administration should be determined to avoid inaccurate dosing. The drug should be discontinued after contractions cease. The client should be placed in the left lateral recumbent position to increase blood flow to the fetus and to increase renal blood flow.

A pregnant woman is administered medication to treat preterm labor that requires a prescription for calcium gluconate to counter the effects of the drug. Which drug was administered? 1 Nifedipine 2 Indomethacin 3 Betamethasone 4 Magnesium sulfate

4 Magnesium sulfate Magnesium sulfate is used to prevent preterm labor in pregnant women with hypertension. To reduce magnesium toxicity caused, calcium gluconate should also be prescribed to counter the effects of this drug. Nifedipine is a calcium channel blocker that inhibits myometrial activity by blocking the calcium influx. Indomethacin is a nonsteroidal antiinflammatory agent used along with sucralfate to protect the stomach. Betamethasone is a corticosteroid used when preterm labor is not maintained by other treatments and delivery is proceeding.

Which statements relate to preterm labor? Select all that apply. 1 A premature baby has good cognitive development. 2 The treatment for preterm labor includes bed rest and hydration. 3 Preterm labor before the 20th week is indicative of a nonviable fetus. 4 It is not desirable to stop the delivery in the case of preterm labor. 5 Preterm labor refers to uterine contractions progressing to delivery before the 27th week of pregnancy.

2 The treatment for preterm labor includes bed rest and hydration. 3 Preterm labor before the 20th week is indicative of a nonviable fetus. Bed rest and hydration are nonpharmacological interventions for treating preterm labor. Early labor pains before 20th week are indicative of a nonviable fetus and should generally be uninterrupted. A preterm labor may result in neonatal death, so pregnancy should be maintained to prevent neonatal death. The substantial uterine contractions before the 37th week of gestation leads to preterm labor. Preterm labor has significant poorer cognitive effects on premature babies.