6 Preterm Labor Nursing Care Plans

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Preterm labor, also called premature labor, is the onset of rhythmic uterine contractions that produce cervical change after fetal viability but before fetal maturity. It usually occurs between the 20th and 37th weeks of gestation.

Nursing Care Plans

Management involves suppression of preterm labor when tests show immature fetal pulmonary development, cervical dilation is less than 4 cm and the absence of factors that contraindicate continuation of pregnancy.

The nurse should monitor closely for signs of fetal or maternal distress, and provide comprehensive supportive care for patients with preterm labor.

Here are six (6) nursing care plans and nursing diagnosis for preterm labor:

  1. Anxiety
  2. Activity Intolerance
  3. Risk for Poisoning
  4. Risk for [Fetal] Injury
  5. Acute Pain
  6. Deficient Knowledge
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Risk for [Fetal] Injury

Nursing Diagnosis

  • Risk for Injury

Risk factors

  • Delivery of preterm infant

Possibly evidenced by

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  • [Not applicable]

Desired Outcomes

  • Patient will maintain pregnancy at least to the point of fetal maturity.
Nursing Interventions Rationale
Assess for maternal conditions that would contraindicate steroid therapy to facilitate fetal lung maturity. In PIH and chorioamnionitis, steroid therapy may aggravate hypertension and mask signs of infection. Steroids may increase serum glucose levels in the patient with diabetes. Drug will not be effective if unable to delay birth for at least 48 hours.
Assess FHR; note presence of uterine activity or cervical changes. Prepare to possible preterm delivery. Tocolytics can increase FHR. Delivery may be extremely rapid with small infant if persistent uterine contractions are unresponsive to tocolytics, or if cervical changes continue.
Provide information about the actions and side effects of the drug therapy. Important for the client or couple to know the purpose of the drugs being administered:

  • Beta-agonist therapy: may cause fetal tachycardia, hyperglycemia, acidosis, and hypoxia.
  • Steroid therapy: most effective for increasing lung surfactant when the fetus is between 30 and 32 weeks’ gestation.
Review potential side effects of steroid therapy with client or couple. Short-term effects may include hypoglycemia, increased risk of sepsis, and possible suppression of aldosterone for 2 weeks following delivery.
Stress necessity of follow-up care. If fetus is not delivered within 7 days of administration of steroids, dose should be repeated weekly.
Assist as needed with analysis of amniotic fluid from amniocentesis or vaginal pool specimen; test for ferning. L/S ratio, presence of PG, and shake test results indicate fetal lung status. Ferning indicates rupture of membranes with increased risk of infection.
Administer betamethasone (Celestone) deep IM. Betamethasone is a synthetic cortisol that can accelerate fetal lung maturity by stimulating surfactant production and thereby preventing or decreasing the severity of respiratory distress syndrome. Administration into the deltoid muscle may result in local atrophy.
Administer antibiotics, as indicated. In the event of PROM and fetal lung immaturity, antibiotics may be used to prevent or reduce risk of infection, while allowing an additional 24 hours to elapse after administration of Celestone.
Initiate tocolytic therapy, as ordered. Helps reduce myometrial activity to prevent or delay early delivery.
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See Also

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Maternal and Newborn Care Plans

Nursing care plans related to the care of the pregnant mother and her infant. See care plans for maternity and obstetric nursing:

Matt Vera is a registered nurse with a bachelor of science in nursing since 2009 and is currently working as a full-time writer and editor for Nurseslabs. During his time as a student, he knows how frustrating it is to cram on difficult nursing topics. Finding help online is nearly impossible. His situation drove his passion for helping student nurses by creating content and lectures that are easy to digest. Knowing how valuable nurses are in delivering quality healthcare but limited in number, he wants to educate and inspire nursing students. As a nurse educator since 2010, his goal in Nurseslabs is to simplify the learning process, break down complicated topics, help motivate learners, and look for unique ways of assisting students in mastering core nursing concepts effectively.

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