Questions and Answers
What is a possible complication of overusing oxytocin during labor?
Why is it important to monitor the client's intake and output during oxytocin infusion?
What is the recommended rate of IV fluids administration during oxytocin infusion?
Why is it important to note the color and amount of amniotic fluid after rupture?
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What should the nurse do if contractions exceed 70-90 seconds during oxytocin infusion?
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Why is it important to have oxygen, suction, and resuscitation equipment readily available during oxytocin infusion?
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What may occur if the fetus is excessively large?
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What is the purpose of amniotomy?
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What is a possible risk to the fetus in postterm labor?
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What is the purpose of stripping the membranes?
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Why is an ultrasound examination used in postterm labor?
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What is a nursing management strategy in postterm labor?
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What is the purpose of oxytocic administration?
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What may be a complication in postterm labor?
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What is a sign of placental dysfunction?
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What may occur if the fetus is suffering from placental dysfunction?
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What is fetal distress described as?
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What is the recommended position for the client to minimize pressure on the cord in case of prolapsed cord?
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What is the term used to describe a difficult, painful, prolonged labor due to mechanical factors?
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What is the purpose of radiologic pelvimetry?
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What is the term used to describe a situation where the head of the baby is disproportionate to the mother's pelvis?
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What is the recommended nursing intervention to conserve energy in a client experiencing fetal distress?
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What is the term used to describe an unusually large fetus?
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What is the recommended nursing intervention to promote a therapeutic relationship with the client experiencing fetal distress?
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What is the term used to describe ineffective uterine contractions secondary to muscle fatigue or overstretching?
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What is the recommended nursing intervention to assess fetal heart tones in a client experiencing fetal distress?
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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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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.
