Show:
Uterotonics
Preterm Labor
Tocolytics
L & D Complications
Nursing Interventions
100

This medication is contraindicated with hypertension.

What is Methergine?

100

Preterm labor is defined as regular uterine contractions that result in cervical change between these weeks of gestation.

What is 20 weeks through 36 6/7 weeks gestation?

100

This calcium channel blocker is commonly prescribed as a first-line oral tocolytic to suppress preterm labor.

What is Nifedipine/Procardia?

100

A patient at 30 weeks presents with contractions, leaking fluid, temperature 101.4°F, and fetal tachycardia. Which complication is the nurse most concerned about?

What is chorioamnionitis or an intraamniotic infection (IAI)?

100

This assessment should be performed immediately after a laboring patient is admitted to determine fetal well-being.

What is assessing the fetal heart rate (or applying electronic fetal monitoring)?

200

A patient has a postpartum hemorrhage despite receiving Pitocin. She also has asthma. Which uterotonic medication should the nurse question?

What is Carboprost (Hemabate)?

200

This medication is given to accelerate fetal lung maturity if preterm birth is anticipated.  

What is Betamethasone (Celestone)?

200

This medication is administered during preterm labor to provide fetal neuroprotection, decrease the risk of maternal seizures in patients with preeclampsia, and may also be used to slow uterine contractions for a short period.

What is Magnesium Sulfate?

200

This is the first maneuver the nurse should anticipate during a shoulder dystocia emergency.

What is the McRoberts maneuver?

200

After a patient's membranes rupture spontaneously or an amniotomy is performed, the nurse's priority intervention is to assess this first.

What is the fetal heart rate?

300

This is the first-line medication for the prevention and treatment of postpartum hemorrhage.

What is Oxytocin (Pitocin)?

300

Which nursing intervention has the highest priority immediately after Preterm Premature Rupture of Membranes (PPROM)? 

What is assess fetal heart rate?

300

This NSAID tocolytic is most appropriate for patients less than 32 weeks gestation because use later in pregnancy may cause premature closure of this fetal structure.

What is Indomethacin (Indocin)?

300

Name three nursing responsibilities following a vacuum-assisted delivery.

What is:

  • Assess newborn scalp and neurologic status
  • Monitor for signs of intracranial or subgaleal bleeding
  • Assess maternal perineum for lacerations
  • Monitor newborn vital signs
  • Educate parents regarding expected scalp swelling
300

A laboring patient develops recurrent late decelerations. Before notifying the provider, the nurse should reposition the patient into this position to improve uteroplacental perfusion.

What is the left lateral (side-lying) position?

400

This prostaglandin medication is commonly used for cervical ripening, labor induction, and the treatment of postpartum hemorrhage.

What is Misoprostol (Cytotec)?

400

A 30-week pregnant patient arrives reporting contractions every 3 minutes and pelvic pressure. The cervix is 3 cm dilated. List four priority nursing interventions during the first hour of care.

What is:

  • Apply continuous fetal and contraction monitoring.
  • Notify the provider.
  • Establish IV access and begin fluids if ordered.
  • Administer corticosteroids (Betamethasone) as ordered.
  • Administer Magnesium Sulfate for fetal neuroprotection if indicated.
  • Administer a tocolytic if ordered and appropriate.
  • Monitor maternal vital signs and assess cervical/labor progression.
  • Provide patient education and emotional support.
400

Name four nursing assessments required while administering Magnesium Sulfate.

What is:

  • Respiratory rate
  • Deep tendon reflexes
  • Urine output
  • Level of consciousness
    (Bonus: monitor fetal heart rate and serum magnesium levels if ordered.)
400

The newborn complication most associated with meconium-stained fluid.  

What is Meconium Aspiration Syndrome (MAS)?

400

A patient receiving oxytocin is experiencing contractions every 60 seconds that last 100 seconds, and the fetal heart rate begins to show late decelerations. What is the nurse's priority intervention? What is the condition causing the fetal bradycardia called?

What is stop the oxytocin infusion?

What is Tachysystole? 

500

Name three uterotonics and one major contraindication for each.

  • Methergine → Hypertension
  • Hemabate → Asthma
  • Pitocin → Contraindicated with fetal distress when vaginal birth is not imminent (or significant cephalopelvic disproportion)
  • Cytotec → Previous classical uterine incision (for induction)
500

Name three common signs and symptoms of preterm labor.

What is: 

  • Regular contractions
  • Pelvic pressure
  • Low back pain
  • Menstrual-like cramping
  • Increased vaginal discharge
  • Vaginal spotting
500

Your patient is 30 weeks pregnant and is contracting every 2 minutes. Name at least 2 medications that the provider may order to delay labor?

What is:

  • Terbutaline
  • Nifedipine
  • Magnesium Sulfate
  • Indomethacin (if appropriate gestational age)
500

Name two fetal signs and two maternal signs that may indicate uterine rupture.

What is:

Fetal:

  • Bradycardia
  • Late decelerations
  • Loss of fetal station
  • Non-reassuring fetal heart rate

Maternal:

  • Sudden severe abdominal pain
  • Vaginal bleeding
  • Loss of contractions
  • Maternal shock
500

List four priority nursing interventions that should be performed routinely while caring for a patient in active labor.

What is:

  • Monitor fetal heart rate.
  • Assess contraction frequency, duration, and intensity.
  • Assess maternal vital signs.
  • Evaluate labor progress (cervical dilation, effacement, station, as appropriate).
  • Provide pain management and comfort measures.
  • Encourage position changes and mobility when appropriate.
  • Support hydration and bladder emptying.
  • Provide emotional support and patient education.
  • Maintain a safe environment and prepare for delivery as labor progresses.