LABOR Induced_Augmented - LABORInduced/Augmented...

Info icon This preview shows pages 1–3. Sign up to view the full content.

View Full Document Right Arrow Icon
LABOR Induced/Augmented This plan of care concerns the induction of labor for maternal health problems, fetal compromise, or postmaturity  (medically indicated inductions), and the augmentation of labor in uterine dysfunction. For optimal use of this plan of  care, combine it with the previous plans of care in this chapter, concerning the normal stages of labor and dysfunctional  labor, as appropriate. CLIENT ASSESSMENT DATA BASE Circulation BP elevation (possibly anxiety or pregnancy-induced hypertension [PIH]); decrease (suggests supine hypotension or  dehydration) Food/Fluid Maternal weight loss of 2.5–3 lb (may be associated with postmaturity or fetal weight loss) Neurosensory Deep tendon reflexes may be brisk 3+ with PIH; presence of clonus indicates severe excitability. Pain/Discomfort Uterine palpation may reveal dysfunctional contractile pattern. Safety May experience SROM without contractions. Elevated temperature (infection in presence of prolonged rupture of membranes). FHR may be greater than 160 bpm if preterm, hypoxic, or septic. Fetal size may indicate weight loss; fetal demise. Greenish amniotic fluid (fetal distress in vertex presentation). Presenting part below the pelvic inlet. Fundus may be lower than anticipated for term, with intrauterine growth retardation/restriction (IUGR) associated with  maternal vascular involvement. History/presence of Rh isoimmunization, chorioamnionitis, diabetes, PIH not controlled by medical therapy, chronic  hypertension, postmaturity, cyanotic maternal cardiac disease, or renal disease; or previous cesarean delivery  with low transverse incision (vertical incision is contraindication). Sexuality Precipitous (or rapid) labor with previous pregnancy; client lives a distance from the hospital. Cervix may be ripe (approximately 50% effacement and 2–3 cm dilated). Uterine inertia may occur. Bloody show may be present with dilation. Increased vaginal bleeding (placenta previa or abruptio placentae are contraindications). May be 42 weeks’ gestational age or more. DIAGNOSTIC STUDIES Complete Blood Count with Differential (CBCD):  Determines presence of anemia and infection, as well as level of  hydration. Blood type and Rh factor,  if not previously done. Urinalysis:  Reveals urinary tract infection, protein, or glucose. Lecithin to Sphingomyelin Ratio:  Determines fetal maturity. Nitrazine Paper and/or Fern Test:  Confirms rupture of membranes. Scalp pH:  Indicates degree of fetal hypoxia/fetal metabolic reserves.
Image of page 1

Info iconThis preview has intentionally blurred sections. Sign up to view the full version.

View Full Document Right Arrow Icon
Ultrasonography:  Determines gestational age, fetal size, presence of fetal heart motion, and location of the placenta.
Image of page 2
Image of page 3
This is the end of the preview. Sign up to access the rest of the document.

{[ snackBarMessage ]}

What students are saying

  • Left Quote Icon

    As a current student on this bumpy collegiate pathway, I stumbled upon Course Hero, where I can find study resources for nearly all my courses, get online help from tutors 24/7, and even share my old projects, papers, and lecture notes with other students.

    Student Picture

    Kiran Temple University Fox School of Business ‘17, Course Hero Intern

  • Left Quote Icon

    I cannot even describe how much Course Hero helped me this summer. It’s truly become something I can always rely on and help me. In the end, I was not only able to survive summer classes, but I was able to thrive thanks to Course Hero.

    Student Picture

    Dana University of Pennsylvania ‘17, Course Hero Intern

  • Left Quote Icon

    The ability to access any university’s resources through Course Hero proved invaluable in my case. I was behind on Tulane coursework and actually used UCLA’s materials to help me move forward and get everything together on time.

    Student Picture

    Jill Tulane University ‘16, Course Hero Intern