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IM 24 hours apart) to promote fetal lung maturity if the gestational age is less than 34 weeks and childbirth can be delayed for 48 hours. -Given to pregnant women with signs of preterm labor between 24 and 34 weeks’ gestation. It stimulates the production of surfactant in the preterm infant and accelerates fetal lung maturity. MgSo4: depresses the my myometrium contractility, relaxing the smooth muscle of the uterus -Adm continuous IV infusion via Pump -Initial Dose of 4-6g in 20 min then.. 2g/hr
-Therapeutic level 5-8 mg/dL in maternal serum levels -Monitor serum levels: Resp Depression is a sign of Mg toxicity > 9 -Contraindication = MG Chapter 10 High-risk Intrapartum Indications for induction of labor: 14. Tachysystole(Hyperstimulation of uterus) due to Pitocin & Interventions > Excessive uterine activity causes a decrease in blood flow in the intervillous space where oxygen is exchanged > Low O2 to the fetus = hypoxemia, abnormal FHR ➔Clinical Findings:◆5 > UC within 10 min or over 30 min ◆UC’s 1 min apart ◆UC’s lasting 2 min ➔Nursing Actions: CATEGORY 1 ◆Reposition ◆IV Bolus LR’s ◆Decrease rate of Oxytocin by at least half ◆Discontinue Oxytocin if persistent ➔Nursing Actions: CATEGORY 2 ◆Discontinue Oxytocin ◆Reposition ◆IV Bolus LR’s ◆Consider O2 8-10L w/ non-rebreather mask ◆Notify HCP ◆If no response, consider Terbutaline 15. Indications for C-section ➔Dysfunctional Labor: abnormal UC’s preventing cervical dilation & descent of fetus◆Hypertonic Uterine Dysfunction: uncoordinated uterine activity ●Frequent UC but ineffective in promoting dilation or effacement ●“Prodromal Labor” ●At risk for exhaustion RT prolonged labor ●At risk for fetal intolerance of labor & asphyxia RT decreased placental perfusion ●Risk Factors:Nulliparous ●Assessment Findings 1. Dystocia: abnormal labor causing abnormalities in power, passenger or passage ○Risk Factors ■Tachysystole of the Uterus w/ Oxytocin ■Congenital Uterine abnormalities ■Cephalopelvic Disproportion ■Maternal Fatigue/Dehydration ■Adm analgesia/anesthesia early in labor ■Catecholamine release interfering UC’s from mothers fear/exhaustion ◆Hypotonic Uterine Dysfunction: pressure of UC is insufficient to promote dilation/effacement = < 25 mm Hg ●Mother’s UC’s become Weak & less effective but may have normal progress in latent phase of labor ●Risks○Multiparous ○Extreme fear = catecholamine release ●Assessment Findings
○PAINFUL UC’s w/little or no cervical change ○Category 2 or 3 FHR ●Nursing Actions ○Promote REST for the mother by Adm pain meds ◆Demerol ◆Morphine ○Promote RELAXATION ◆Warm bath/shower ◆Quiet environment ◆No sleep interruption ○IV/PO fluids to < dehydration ○Monitor FHR & UC’s ○Sterile Vaginal Exam (SVE) to evaluate progress ○Support pt & fam & update HCP ★Hypotonic labor patterns increase risk for infection and maternal exhaustion, with fetal distress occurring