Postterm Labor Risks and Assessment
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Questions and Answers

What is a possible complication of overusing oxytocin during labor?

  • Uterine atony (correct)
  • Perineal laceration
  • Anoxia
  • Uterine inversion

    • Why is it important to monitor the client's intake and output during oxytocin infusion?

  • To prevent perineal laceration
  • To prevent postpartum hemorrhage
  • To prevent hypovolemic shock
  • To prevent water intoxication (correct)

    • What is the recommended rate of IV fluids administration during oxytocin infusion?

  • 200mL/hour
  • 300mL/hour
  • 100mL/hour
  • 150mL/hour (correct)

    • Why is it important to note the color and amount of amniotic fluid after rupture?

    <p>To monitor for signs of infection and sepsis</p> Signup and view all the answers

    What should the nurse do if contractions exceed 70-90 seconds during oxytocin infusion?

    <p>Discontinue the infusion</p> Signup and view all the answers

    Why is it important to have oxygen, suction, and resuscitation equipment readily available during oxytocin infusion?

    <p>In case of anoxia</p> Signup and view all the answers

    What may occur if the fetus is excessively large?

    <p>Cephalopelvic disproportion</p> Signup and view all the answers

    What is the purpose of amniotomy?

    <p>To initiate labor contractions</p> Signup and view all the answers

    What is a possible risk to the fetus in postterm labor?

    <p>Hypoglycemia and asphyxia</p> Signup and view all the answers

    What is the purpose of stripping the membranes?

    <p>To separate the membranes from the lower uterine segment</p> Signup and view all the answers

    Why is an ultrasound examination used in postterm labor?

    <p>To determine fetal size</p> Signup and view all the answers

    What is a nursing management strategy in postterm labor?

    <p>Carefully assess the fetus to identify risk</p> Signup and view all the answers

    What is the purpose of oxytocic administration?

    <p>To initiate labor contractions</p> Signup and view all the answers

    What may be a complication in postterm labor?

    <p>Anoxia</p> Signup and view all the answers

    What is a sign of placental dysfunction?

    <p>Weight loss and decreased uterine size</p> Signup and view all the answers

    What may occur if the fetus is suffering from placental dysfunction?

    <p>Hypoglycemia and asphyxia</p> Signup and view all the answers

    What is fetal distress described as?

    <p>Fetal hypoxia that may result in fetal damage/death if not reversed or the fetus delivered immediately</p> Signup and view all the answers

    What is the recommended position for the client to minimize pressure on the cord in case of prolapsed cord?

    <p>Knee-chest position</p> Signup and view all the answers

    What is the term used to describe a difficult, painful, prolonged labor due to mechanical factors?

    <p>Dystocia</p> Signup and view all the answers

    What is the purpose of radiologic pelvimetry?

    <p>To measure the pelvic diameter</p> Signup and view all the answers

    What is the term used to describe a situation where the head of the baby is disproportionate to the mother's pelvis?

    <p>Cephalopelvic Disproportion</p> Signup and view all the answers

    What is the recommended nursing intervention to conserve energy in a client experiencing fetal distress?

    <p>Instructing the client to change positions on the bed regularly</p> Signup and view all the answers

    What is the term used to describe an unusually large fetus?

    <p>Fetal Macrosomia</p> Signup and view all the answers

    What is the recommended nursing intervention to promote a therapeutic relationship with the client experiencing fetal distress?

    <p>Conveying empathy and unconditional positive regard</p> Signup and view all the answers

    What is the term used to describe ineffective uterine contractions secondary to muscle fatigue or overstretching?

    <p>Uterine Inertia</p> Signup and view all the answers

    What is the recommended nursing intervention to assess fetal heart tones in a client experiencing fetal distress?

    <p>Performing continuous electronic fetal monitoring</p> Signup and view all the answers

    Study Notes

    Postterm Labor Risks

    • Decreased amniotic fluid may lead to cord compression during labor.
    • Decreased placental function (aging) lowers O2 and nutritional transport, which can compromise the fetus during labor, leading to hypoglycemia and asphyxia.
    • Induction of labor may be mechanical (amniotomy), physiologic (ambulation and nipple stimulation), or chemical (prostaglandins and oxytocin).

    Assessment Findings

    • Weight loss and decreased uterine size may indicate placental dysfunction.
    • Excessively large uterus may indicate fetal macrosomia.
    • Meconium-stained fluid and nonreassuring FHR patterns may indicate fetal distress.

    Nursing Management

    • Assess the fetus to identify risks and closely monitor fetal status.
    • Assist with induction of labor and prepare for a difficult delivery.
    • Notify pediatric staff for potential birth injuries and provide emotional and physical support.

    Labor Induction Methods

    • Amniotomy: artificial rupture of membranes to stimulate stronger contractions.
    • Stripping the membranes: separating membranes from the lower uterine segment to dilate the cervix.
    • Oxytocic administration: intravenous administration of oxytocin to initiate and sustain uterine contractions.

    Intrapartum Complications

    • Fetal distress: fetal hypoxia that may result in fetal damage or death if not reversed.
    • Etiology: cord compression, oligohydramnios, hypovolemia, and pre-existing hypoxia or growth retardation.

    Fetal Distress Management

    • Monitor heart sounds and uterine contractions continuously.
    • Urge the woman to void every 2 hours and assess FHR carefully.
    • Establish a therapeutic relationship, conveying empathy and unconditional positive regard.

    Cephalopelvic Disproportion

    • Implies disproportion between the head of the baby and the mother's pelvis.
    • Can lead to difficult labor, painful, prolonged labor, or even cesarean section.

    Dystocia/Dysfunctional Labor

    • Defined as a difficult, painful, prolonged labor due to mechanical factors.
    • Etiology: fetal factors (passenger), uterine factors (power), pelvic factors (passageway), and pyschic factors.
    • Pathophysiology: uterine contractions are ineffective secondary to muscle fatigue or overstretching.

    Nursing Management for Dystocia

    • Optimize uterine activity.
    • Monitor uterine contractions for dysfunctional patterns.
    • Prevent unnecessary fatigue, and prepare for tocolytic therapy if necessary.

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    Related Documents

    Maternal and Child Health Nursing Midterm PDF

    Description

    Learn about the risks associated with postterm labor, including decreased amniotic fluid and placental function, and how to assess fetal well-being during labor.

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