Nursing Care of Women with Complications During Labor and Birth PDF

8/15/2024 Chapter 8 Nursing Care of Women with Complications During Labor and Birth Niomi Quinteros, BSN, RN 1 Indications Contraindications 2 1 ...

8/15/2024 Chapter 8 Nursing Care of Women with Complications During Labor and Birth Niomi Quinteros, BSN, RN 1 Indications Contraindications 2 1  8/15/2024 3 Amniotomy Nursing Interventions Record FHR for at least 1 minute after amniotomy Note color, odor, amount, character, time: if fluid is green notify MD Maternal temp taken every 2-4 hours notify MD if temp 100.4 or higher Change under pads often 4 2  8/15/2024 5 Amnioinfusion Oligohydramnios Umbilical cord compression Reduce recurrent variable decelerations Dilute meconium- stained amniotic fluid 6 3  4 8/15/2024 Nursing Care? 7 8  8/15/2024 9 10 5  8/15/2024 11 12 6  8/15/2024 Review Care Plan 13 14 7  8/15/2024 15 Risks of Prolonged Labor Maternal or newborn infection Maternal exhaustion Postpartum hemorrhage Greater anxiety and fear 16 8  8/15/2024 Rupture of Membranes Premature Rupture of Preterm Premature Rupture of Membranes Membranes Spontaneous ROM at term more Spontaneous ROM before term than 1 hour before labor with or without contractions contractions Risk Factors Vital Signs Box 8.1 Fetal tachycardia Complications Uterine tenderness Infection Prolapsed cord Teaching Placental abruption Fetal immaturity factors 17 18 9  8/15/2024 Given to decrease the chance of cerebral palsy to the newborn 19 20 10  8/15/2024 EMERGENCY 21 22 11  8/15/2024 Foley Bulb Forceps https://www.youtube.com/w https://www.youtube.com/w atch?v=f5wvBkbc3zk atch?v=_InLgIcaNcA IUPC Vacuum https://www.youtube.com/watch https://www.youtube.com/watc ?v=anvnHxUCat4 h?v=AShsPCHs7og Vaginal Birth FSE https://www.youtube.com/watc https://www.youtube.com/watch h?v=ZDP_ewMDxCo ?v=TnNEIIOX8OA C/S Birth https://www.youtube.com/watc h?v=pSJcxYg1QQ4 23 After an amniotomy, which observation should be reported immediately? A. Clear fluid draining on the under pad B. Maternal temperature of 37.2 C (99.0 F) C. Fetal heart rate of 95 bpm D. Moderate contractions every 3 minutes 24 12  8/15/2024 A woman, gravida 4, para 3, has been 5 cm dilated for 2 hours. Her contractions are every 7 minutes, 30 second duration, and mild. The FHR is 135-145/minute. She is relatively comfortable. Which is this woman most likely experiencing? A. Hypotonic labor dysfunction B. Hypertonic labor dysfunction C. Occiput posterior fetal position D. Fetal shoulder dystocia 25 After a vaginal birth complicated by a shoulder dystocia, the nurse should particularly assess the newborn for: A. Molding of the head B. Flexed positioning C. Clavicle fracture D. Abnormal temperature 26 13  8/15/2024 A woman has ruptured membranes at 31 weeks gestation. Which nursing observation should be promptly reported? A. FHR: accelerations present; average rate of 145 bpm B. Small quantity of clear, nonirritating vaginal discharge C. Spontaneous fetal movement with uterine palpation D. Maternal vital signs: T 38.2 C (100.7 F), P 102, R 20 27 External version is most likely to be done in which of these situations? A. Early labor with frank breech presentation B. Breech presentation with placenta previa C. Twins in cephalic and breech presentation D. Breech presentation at 38 weeks gestation 28 14  8/15/2024 The first nursing action if a visibly prolapsed umbilical cord occurs is to: A. Call the health care provider B. Palpate the cord for a pulse C. Apply the internal fetal monitor D. Relieve pressure on the cord 29 Which nursing intervention will most likely make the woman with a perineal laceration more comfortable during the first 2 hours after birth? A. Warm water soaks B. A small dressing C. An ice pack D. Antibacterial ointment 30 15