Precipitous Labor -...

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Precipitous Labor/Delivery or Unplanned/Out-of-Hospital  Delivery Rapid progression of labor, lasting less than 3 hr from onset to delivery, and out-of-hospital delivery are  emergency situations that place the client/fetus at increased risk for complications and/or untoward outcomes. The  attending nurse may have primary responsibility for the safety of the mother and fetus. CLIENT ASSESSMENT DATA BASE Ego Integrity Irritability Food/Fluid Nausea/vomiting Pain/Discomfort May have an unusually high pain threshold or not be aware of abdominal contractions Possible absence of palpable contractions, as occurs with maternal obesity Low back discomfort (may not be recognized as a sign of progressing labor) Intense/prolonged uterine contractions; inadequate uterine relaxation between contractions Involuntary urge to bear down Safety Accelerated cervical dilation and fetal descent Preterm or small-for-gestational age infant (increases potential for rapid labor/delivery) Rectal/perineal bulging Increased vaginal show Sexuality History of short or rapid labor Young maternal age; large pelvis Multiparity or previous vaginal surgery (decreases soft-tissue resistance) NURSING PRIORITIES 1. Promote maternal and fetal/newborn well-being. 2. Provide a physiologically and psychologically safe experience for client and newborn. 3. Prevent complications. NURSING DIAGNOSIS: Anxiety [specify level] May Be Related To: Situational crisis, threat to self/fetus, interpersonal transmission Possibly Evidenced By: Increased tension; scared, fearful, restless/jittery; sympathetic  stimulation DESIRED OUTCOMES/EVALUATION  Use breathing and relaxation techniques  CRITERIA—CLIENT WILL: effectively. Cooperate with necessary preparations for a rapid delivery. Follow directions and/or actively participate in delivery process.
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ACTIONS/INTERVENTIONS RATIONALE Independent Maintain calm, deliberate manner. Offer clear,  An emergency or extremely rapid delivery  concise instructions and explanations. occurring out of the hospital or in a hospital setting  without the presence of a clinician (physician or  nurse midwife) can be extremely anxiety-provoking  for the client/couple, who had anticipated an orderly  progression through labor and delivery. When the  actual birth event is not in keeping with their  expectations, reactions may include hostility, fear,  and disappointment. Composure of nurse reassures  client and prevents transmission of undue concern  and anxiety.
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This note was uploaded on 02/01/2011 for the course PNR 182 taught by Professor Toole during the Spring '10 term at Orangeburg-Calhoun Technical College.

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Precipitous Labor -...

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