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Concept Map on Preterm Labor
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Preterm Labor with the concept of health promotion
By Megan Fenner
Case Study:
Case Study
- LD is a 29 year old woman, Caucasian, non-religious, who is 29 weeks gestation with her third pregnancy.
- G3 P2 T0 A1 L1
- Diagnosed with gestational diabetes at 24 weeks gestation
- History of preterm birth at 28 weeks and spontaneous abortion at 12 weeks
- Came into the ED with low back pain and abdominal cramping.
Vital Signs:
Vital Signs & Assessment
BP: 118/92, HR: 86, O2: 99%,
Temp: 98.4, RR: 16, pain: 4/10
Fundal height: 29 cm
Cervical dilation: 3 cm
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The diagnosis of preterm labor is based on three major diagnosis criteria:
1. Gestational age between 20 0/7 and 36 6/7 weeks
2. Regular uterine contractions, accompanied by change in cervical effacement, dilation, or both.
3. Initial presentation with regular contractions and cervical dilation of at least 2 cm.
What should you be teaching your patient about preterm labor?
Teaching Your Patient:
- signs and symptoms of preterm labor
- what to do when symptoms occur
- activity restriction
- restricition of sexual activity
- prophylactic progesterone supplementation
Teaching
Nursing Diagnosis
Deficient knowledge related to insufficient information as evidenced by lack of knowledge of new diagnosis of preterm labor.
Nursing Diagnosis
Diagnostic Tests:
- cervical length
- fetal fibronectin test
Diagnostic Tests
Interventions:
- administration of tocolytics: Magnesium sulfate
Beta-Adrenergic Agonists
Prostaglandin Synthetase Inhibitors
Calcium Channel Blockers
- antenatal clucocorticoids
Interventions
Discharge Planning
- Bedrest at home with children
- Evaluate support and resources that are available
- Maintain a calm, soothing atmosphere, and ecourage family to provide emotional support
- Teach about stress management and relaxation techniques
- Discuss any fears LD or family have
Questions?
References:
Perry, S. et. al. (2018). Maternal child nursing care, sixth edition. St. Louis, MO: Elsevier.