Nursing Care Plan – Preterm Labor

Preterm labor is defined as uterine contractions occurring after 20 weeks of gestation and before 37 completed weeks of gestation. Risk factors include multiple gestation, history of previous preterm labor of delivery, abdominal surgery during current pregnancy, uterine anomaly, history of cone biopsy, maternal age younger than 20 or older than age 35.

CLINICAL MANIFESTATIONS

  1. Low back pain
  2. Suprapubic pressure
  3. Vaginal presure
  4. Rhythmic uterine contrations
  5. Cervical dilation and effacement
  6. Possible rupture of membranes
  7. Expulsion of the cervical mucus plug
  8. Bloody show

NURSING MANAGEMENT

  1. Assess the mother’s condition and evaluate-signs of labor.
    • Obtain a thorough obstetric history
    • Obtain specimens for complete blood count and urinalysis
    • Determine frequency, duration, and intensity of uterine contractions
    • Determine cervical dilation and effacement
    • Assess status of membranes and bloody show
  2. Evaluate the fetus for distress, size, and maturity (sonography and lecithin-sphingomyelin ratio)
  3. Perform measures to manage or stop preterm labor
    • Place the client on bed rest in the side-lying position
    • Prepare for possible ultrasonography, amniocentesis, tocolytic drug therapy, and steroid theraphy
    • Administer tocolytic (contraction-inhibiting) medications as prescribed.
    • Assess for side effects of tocolytic therapy (eg, decreased maternal blood pressure, dyspnea, chest pain, and FHR exceeding 180 beats/min)
  4. Provide physical and emotional support. Provide adequate hydration
  5. Provide client and family education

NursingCrib.com Nursing Care Plan Preterm Labor by deric

Daisy Jane Antipuesto RN MN

Currently a Nursing Local Board Examination Reviewer. Subjects handled are Pediatric, Obstetric and Psychiatric Nursing. Previous work experiences include: Clinical instructor/lecturer, clinical coordinator (Level II), caregiver instructor/lecturer, NC2 examination reviewer and staff/clinic nurse. Areas of specialization: Emergency room, Orthopedic Ward and Delivery Room. Also an IELTS passer.

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