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:

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

Nursing Diagnosis

  • Deficient Knowledge

May be related to

  • Misinterpretation or lack of information

Possibly evidenced by

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  • Request for information
  • Verbalization of misconceptions

Desired Outcomes

  • Patient will verbalize awareness of implications and possible outcomes of preterm labor.
  • Patient will identify signs and symptoms requiring evaluation and intervention.
  • Patient will demonstrate understanding of home therapy and/or self-care needs.
Nursing Interventions Rationale
Ascertain client’s knowledge about preterm labor and possible outcomes. Establishes baseline assessment and identifies needs.
Assess client readiness to learn. Factors such as anxiety or lack of awareness of need for information can interfere with readiness to learn. Retention of information is enhanced when client is motivated and ready to learn.
Include significant others in teaching learning process. Support from significant others can help allay anxiety as well as reinforce principles of teaching and learning.
Provide information about follow-up care when client is discharged. Client may need to return on a regular basis for monitoring and/or treatments.
Identify signs and/or symptoms that should be reported immediately to the healthcare provider (e.g, sustained uterine contractions, clear drainage from vagina, bleeding). Prompt evaluation and interventions may improve the outcome of the pregnancy and avert complications.
With the client, review the signs and symptoms of early labor. Helps the client to recognize preterm labor so therapy can be instituted or reinstituted promptly.
Demonstrate how client is to evaluate contraction activity after discharge (e.g., lying down, tilted to the side with a pillow to the back, placing fingertips on the fundus for approximately 1 hour to note hardening or tightening of the uterus). Although uterine contractions commonly occur periodically, contractions occurring 10 mins or less apart for an hour can result in cervical dilation and labor without prompt intervention. Self-monitoring is usually adequate and has no cost; however, some healthcare providers may require electronic monitoring, which necessitates data be transmitted via telephone lines and interpreted by a nurse upon receipt.
Stress importance of maintaining daily record of uterine activity and other pertinent information as individually appropriate. Periodic review of data will be used to adjust therapy.
Arrange for client to visit neonatal intensive care unit. Helps alleviate fears and facilitates adjustments to situation.
Discuss need to restrict lifestyle by stopping smoking and probably by restricting sexual activity and nipple stimulation. Nicotine has adverse effect on fetoplacental growth and on uterine circulation. Organism or release of oxytocin (from nipple stimulation) may stimulate uterine activity.
Encourage regular rest periods 2-3 times a day in side-lying position. If bedrest is to be continued after discharge, suggest client spend part of day on couch or recliner. Enhances relaxation and reduces fatigue. If client is up and about, resting in the bedroom may maximize rest.
Review daily routine, employment, and activity schedule to identify alternatives and ways to compensate for limitations. Pacing activities, avoidance of heavy chores, lifting, and modification in work duties or cessation of employment may help prevent recurrence of preterm labor.
Determine availability and level of commitment of supportive resources. Division of home care responsibilities helps reduce risk of caregiver burnout when one individual attempts to take on responsibilities of the client in addition to own role.
Advise client to empty bladder every two (2) hours while awake. Prevents pressure of a full bladder on the irritable uterus.
Review daily fluid need; avoid coffee. Dehydration and caffeine both lead to increased uterine muscle irritability.
Stress avoidance of OTC drugs while tocolytic agents are being administered unless approved by physician. Concurrent use of OTC drugs may cause deleterious effects, especially if OTC drug has similar side effects to tocolytic agents.
Recommend adhering to predetermined schedule for oral drug therapy. Maintains blood level of drug for optimum effect.
Provide information about taking oral tocolytics with food. Food improves tolerance to drug and reduces side effects.
Instruct in proper use of infusion pump when use and need to count and/or record pulse before bolus doses are administered. Promotes safe use of drug, enhances participation in therapeutic regimen and supports self-care and independence.
Identify drug side effects requiring medical evaluation. Pulse rate greater than 120 bpm; presence of tremors, palpitations, chest pain, or dyspnea, or feeligns of nervouseness, and agitation may require alterations or discontinuiation of drug.
Establish routine schedule for homecare nurse visitation. Provide regular telephone contact. Weekly or biweekly visits provide opportunity for regular physical assessment, review of uterine activity record, and additional information for education.

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See Also

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Maternal and Newborn Care Plans

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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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