How can you provide non pharmacological comfort to this patient?

Part 1

1. The Centers for Disease Control and Prevention recommends screening for Group B Streptococcus during pregnancy (CDC, 2022).
2. In the absence of GBS screening results, the patient would likely be treated presumptively with antibiotics to protect the premature baby from potential infection (Gibbs & Young, 2021).
3. Other information that may be useful to ask includes the patient’s obstetric history, including any previous preterm births or other complications, as well as any current symptoms such as vaginal discharge or bleeding. Additionally, obtaining information on the patient’s social support and stress levels may be helpful, as these factors have been associated with an increased risk of preterm labor (Rosenberg et al., 2012).
4. Nursing interventions may include monitoring fetal heart rate and uterine contractions, providing emotional support and education on preterm labor prevention measures, such as adequate hydration and rest, and assisting with obtaining any necessary medications or interventions ordered by the provider (Gibbs & Young, 2021).
5. Screening tests that may be obtained to help determine the patient’s risk for preterm labor include cervical length measurement, fetal fibronectin testing, and assessment of bacterial vaginosis (Gibbs & Young, 2021).
6. If the patient is determined to be in preterm labor, medications that may be used with a doctor’s order include tocolytics such as magnesium sulfate or terbutaline to delay delivery and corticosteroids such as betamethasone or dexamethasone to promote fetal lung maturity (Gibbs & Young, 2021).
7. The dose, side effects, and possible results of these medications would be determined by the provider and would depend on the patient’s individual circumstances and medical history.

References:

Centers for Disease Control and Prevention. (2022). GBS Group B Strept (GBS). Retrieved at https://www.cdc.gov/groupbstrep/index.html

Gibbs, R. S., & Young, P. C. (2021). Preterm labor and birth. In R. S. Gibbs, B. L. Karlan, A. F. Haney, & I. Nygaard (Eds.), Danforth’s obstetrics and gynecology (12th ed., pp. 254-277). Wolters Kluwer.

Rosenberg, T. J., Garbers, S., Chavkin, W., Chiasson, M. A., & Susser, M. (2012). In an ethnically diverse group, prepregnancy weights and adverse perinatal outcomes. Obstetrics, Gynecology, and 119(5) 976-982.

Part 2

Other non-pharmacological comfort measures for the patient could include side-lying, sitting straight up, and using heat, cold, and massage to relax. [ACOG], 2021).

Opioids such as fentanyl and morphine can be used as pain management in labor. Regional anesthesia, such as epidural, or spinal anesthesia, could also be used (ACOG, 2021).

If there is no history or prenatal record of Group B Streptococcus (GBS) in the patient’s past, the provider must provide antibiotic prophylactic treatment for labor. This will reduce the chance of developing neonatal infections (ACOG 2021).

There are many non-pharmacological options for augmenting labor. These include upright position and ambulation.