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12.02 Betamethasone and Dexamethasone

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Overview

  1. Purpose: to accelerate fetal lung maturity and decrease severity of respiratory distress
  2. Given IM, 2-4 doses in divided doses  over 48 hours

Nursing Points

General

  1. Given to moms that are in preterm labor  
  2. Medications to accelerate the fetal lung development
  3. Delaying preterm labor for even 48 hours is helpful and allows time to give corticosteroids
  4. Note:  benefits no longer justifiable at 35 weeks

Assessment

  1. Contractions
  2. Assess mother’s blood sugar
    1. Steroids = hyperglycemia
  3. Monitor for infection

Therapeutic Management

  1. Monitoring mother for infection signs
  2. Treat hyperglycemia
  3. Monitor labor and fetal heart rate

Nursing Concepts

  1. Fetal development
  2. Oxygenation
  3. Gas exchange

Patient Education

  1. Medication education

Reference Links

Study Tools

Video Transcript

In this lesson I will explain the use of betamethasone and dexamethasone and using them in practice.

Our biggest concern in preterm labor is the fetal lung maturity. So if a patient is at risk for preterm labor we can try to help this. We give corticosteroids such as betamethasone and dexamethasone to the mother and these will help accelerate the fetal lung maturity prior to delivery. These are given in several doses over the course of 48 hours. If a mom is in preterm labor or and we can prolong it with tocolytics for even 48 hours it is really helpful and allows time to give corticosteroids. Once a fetus is 35 weeks the lungs are thought of as “mature” so it is not necessary after this point if preterm labor starts or is a risk.

Assessment will involve assessing contractions. Is the mother in preterm labor or at risk to be? If so we can give a corticosteroid to accelerate fetal lung development. We now would assess the mother’s blood sugar. Remember we are giving her corticosteroids so this can increase her blood sugar and cause hyperglycemia.Steroids can increase infection risk to mother so we will be assessing for this.

Our management will be to monitor for any infection since steroids can suppress the immune system. We will also monitor and might even treat hyperglycemia caused by the corticosteroids. Education for this patient will just be what we are giving and the process of it being given over a few doses.

Human development, gas exchange, and oxygenation are the concepts because we are giving these medications to accelerate fetal lung development so when born the baby will be able to better oxygenate and perform gas exchange.
Betamethasone and dexamethasone are given when preterm labor is occurring or a preterm delivery is needed. It will accelerate fetal lung maturity. It is given over a few days in split doses and we must watch the client for hyperglycemia and infection.

Make sure you check out the resources attached to this lesson and review uses and side effects of the medications. Now, go out and be your best selves today. And, as always, happy nursing.

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