Questions and Answers
What is hypotonic uterine dysfunction?
Occurs when the pressure of the uterine contractions is insufficient to promote cervical dilation and effacement.
What typically happens during the active labor phase for women with hypotonic uterine dysfunction?
The uterine contractions become weaker and less effective.
Who is at risk for having hypotonic uterine dysfunction?
Multiparous women and those experiencing extreme fear.
Why are multiparous women more at risk for having hypotonic dysfunction?
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How does extreme fear contribute to hypotonic uterine dysfunction?
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What risks does a woman with hypotonic uterine dysfunction face?
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Why is the mother at risk for exhaustion and infection during hypotonic dysfunction?
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What risks does the fetus face when the mother has hypotonic uterine dysfunction?
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What instrument is used to measure the exact intensity of contractions in hypotonic dysfunction?
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What is a Montevideo unit?
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What is the desired range for Montevideo units?
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What does it mean if your Montevideo score is below 200?
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What does it mean if your Montevideo score is above 250?
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What assessment finding suggests hypotonic uterine dysfunction when palpating the uterus?
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What medical management should be put in place for hypotonic dysfunction?
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What should you do if you don't have an IUPC in place but suspect hypotonic dysfunction?
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Why would a vaginal exam be performed in a case of hypotonic dysfunction?
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What should you anticipate if the Montevideo score is less than 200?
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What nursing interventions may be implemented for hypotonic dysfunction?
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Why is hydration important if there are too many weak contractions?
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Why is ambulation or changing position beneficial during hypotonic dysfunction?
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How can emotional support impact labor in cases of hypotonic dysfunction?
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Can oxytocin be given for a hypotonic dysfunction?
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Study Notes
Hypotonic Uterine Dysfunction Overview
- Hypotonic uterine dysfunction occurs when uterine contractions (UCs) lack sufficient pressure to promote cervical dilation and effacement.
- Women typically progress normally during the latent phase but experience weaker, less effective UCs during active labor.
At-Risk Populations
- Multiparous women (those with multiple births) are at greater risk, as their bodies may remember how to contract but not the necessary intensity.
- Women experiencing extreme fear are also at risk due to catecholamine release, which interferes with UCs.
Risks Associated with Hypotonic Uterine Dysfunction
- Prolonged labor leads to risks such as maternal exhaustion and infection.
- Fetal risks include intolerance and asphyxia.
Measuring Contraction Intensity
- An intrauterine pressure catheter (IUPC) is used to measure the exact intensity of contractions.
- The Montevideo unit is a method to quantify labor contractions, aiming for a score between 200 mmHg and 250 mmHg based on uterine activity.
Montevideo Unit Calculation
- The calculation involves obtaining the peak contraction pressure and subtracting the resting tone.
- If the calculated score is below 200 mmHg, it indicates insufficient contractions, suggesting hypotonic dysfunction.
Assessment Findings
- The uterus is easily indentable, even at the peak of a contraction, indicating hypotonicity.
Medical Management
- Ensure placement of an IUPC and conduct a vaginal exam to assess labor progression and cervical dilation.
- Anticipate administering oxytocin (Pitocin) if the Montevideo score is less than 200 mmHg to stimulate stronger contractions.
Nursing Interventions
- Conduct vaginal exams and calculate Montevideo scores.
- Maintain hydration to address contractions that are too weak.
- Monitor fetal heart rate (FHR) tracing and encourage safe ambulation to strengthen contractions.
- Provide emotional support to reduce fear, promoting stronger contractions.
Important Considerations
- Oxytocin can be administered for hypotonic dysfunction only when ordered. Avoid administering it for hypertonic dysfunction, as those contractions are already excessively strong.
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Description
Explore the key concepts of hypotonic uterine dysfunction through these informative flashcards. Understand its definition, the specifics of the condition, and identify who is at risk of experiencing this dysfunction during labor. Perfect for students and practitioners in obstetrics.