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.
- Low back pain
- Suprapubic pressure
- Vaginal presure
- Rhythmic uterine contrations
- Cervical dilation and effacement
- Possible rupture of membranes
- Expulsion of the cervical mucus plug
- Bloody show
- 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
- Evaluate the fetus for distress, size, and maturity (sonography and lecithin-sphingomyelin ratio)
- 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)
- Provide physical and emotional support. Provide adequate hydration
- Provide client and family education