Positioning c section concern with a vaginal delivery

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Unformatted text preview: ates labor, but unclear if it can initiate Facilitates labor labor – Use only in 3rd trimester – Major contraindications---conditions that require ---conditions C-section (head first is the normal positioning) C-section Concern with a vaginal delivery after a C-section is a Concern break in the C-section Uterine Stimulants (Oxytocics) Uterine Oxytocin (Pitocin) Physiologic and pharmacologic effects Uterine stimulation Milk ejection Water retention – Precautions and contraindications Uterine rupture may occur (too much pressure). Uterine The baby will die Women with active genital herpes – Adverse effect – water retention/intoxication Adverse water – Most common fetal adverse effect is Most bradycardia (the contractions are too much for baby to handle) baby Uterine Stimulants (Oxytocics) Uterine Carboprost tromethamine (Hemabate) – Preferred agent for controlling postpartum Preferred hemorrhage hemorrhage – Causes intense uterine contractions – Adverse effects GI reactions Vomiting and diarrhea Fever Vasoconstriction in uterus- affects sytemic Vasoconstriction constriction. Mom’s BP will rise, could result in a stroke Constriction of the bronchi Uterine Stimulants (Oxytocics) Uterine Ergot alkaloids: ergonovine and Ergot methylergonovine---second line drugs for controlling post partum hemorrhage controlling – Not used to induce labor (sustained contractions) – Can cause constriction of arterioles and veins Therapeutic uses Postpartum bleeding (not responsive to oxytocin) Augmentation of labor Migraine – Adverse effects (IV administration) Hypertension---may be severe* Indications for Use of Oxytocin Indications Pregnancy has gone beyond term. Early vaginal delivery is likely. Increased risk of mortality of mother Increased or infant. or Oxytocin Oxytocin Nursing Implications health history--determine possible drug/drug interaction monitor pulse and blood pressure monitor level of consciousness check intake and output monitor fetal heart rate---an increase in force and monitor frequency of uterine contractions may cause fetal distress. distress. monitor fetal presentation do not leave patient unattended if giving IV oxytocin monitor vaginal bleeding monitor lactation status---oxytocin causes milk ejection Cautions for Use of Oxytocin Cautions Multiparity Over distention of Over uterus uterus Invasive cervical Invasive carcinoma carcinom...
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