IM 24 hours apart to promote fetal lung maturity if the gestational age is less

Im 24 hours apart to promote fetal lung maturity if

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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
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-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 fetusHypertonic 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 RisksMultiparous Extreme fear = catecholamine release Assessment Findings
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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
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