Ch. 8 - Compllications During Labor & Birth

Ch. 8 - Compllications During Labor & Birth -...

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Nursing Care of Women with Complications During Labor and Birth Chapter 8
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Obstetric Procedures Slide 2 Amnioinfusion Oligohydramnios Umbilical cord compression Reduction of recurrent variable decelerations Dilution of meconium-stained amniotic fluid Replaces the “cushion” for the umbilical cord and relieves the variable decelerations
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Obstetric Procedures (continued) Slide 3 Amniotomy The artificial rupture of membranes Done to stimulate or enhance contractions Stimulates prostaglandin secretion Complications Prolapse of the umbilical cord Infection Abruptio placentae
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Obstetric Procedures (continued) Slide 4 Observe for complications after amniotomy Fetal heart rate outside normal range (110 to 160 beats/min) suggest umbilical cord prolapse Observe color, odor, amount, and characteristics of amniotic fluid Woman’s temperature, 38° C (100.4° F) or higher, is suggestive of infection Green fluid may indicate that the fetus has passed a meconium stool
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Nursing Tip Slide 5 Observe for wet underpads and linens after the membranes rupture Change wet underpads and linens as often as needed to keep the woman relatively dry and to reduce the risk for infection or skin breakdown
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Obstetrics Procedure Slide 6 Induction is the initiation of labor before it begins naturally Augmentation is the stimulation of contractions after they have begun naturally
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Indications for Labor Induction Slide 7 Gestational hypertension Ruptured membranes without spontaneous onset of labor Infection within the uterus Medical problems in the woman that worsen during pregnancy Fetal problems, such as slowed growth, prolonged pregnancy, or incompatibility between fetal and maternal blood types Placental insufficiency Fetal death
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Contraindications to  Labor Induction Slide 8 Placenta previa Umbilical cord prolapse Abnormal fetal presentation High station of the fetus Active herpes infection in the birth canal Abnormal size or structure of the mother’s pelvis Previous classic cesarean incision
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Pharmacological Methods  to Stimulate Contractions Slide 9 Cervical ripening Prostaglandin in a gel or vaginal insert is applied before labor induction to soften the cervix Laminaria is an alternative to cervical ripening by swelling inside the cervix Oxytocin induction and the augmentation of labor Used to initiate or stimulate contractions Most commonly used method
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Benefit of Augmentation Slide 10 Usually requires less total oxytocin than induction Uterus is more sensitive to the drug when labor has already begun
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Nonpharmacological Methods  to Stimulate Contractions Slide 11 Walking Stimulates contractions Eases pressure of the fetus on the mother’s back Adds gravity to the downward force of contraction Nipple stimulation Causes the pituitary gland to secrete natural oxytocin
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Ch. 8 - Compllications During Labor & Birth -...

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