In a precipitate delivery in which there is no

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In a precipitate delivery in which there is no physician present, the nurse should apply gentle pressure to the perineum and deliver the head between contractions A previous C-section delivery is an indication for subsequent pregnancies and deliveries except if the uterine scar is low transverse. Meconium stained amniotic fluid is associated with fetal compromise. When a woman lies on her back during active labor, she may experience supine hypotension syndrome Cultural Influences: Japanese: natural childbirth, may labor silently Chinese: Stoic response to pain, side-lying position for labor and birth. India: Female relatives present Laos: May use squatting position for birth. Post-partum assessment The fundus should be palpated in the midline of abdomen, if the woman has full bladder however, the fundus may be deviated to the right or left A boggy (soft and poorly contracted) fundus signals uterine atony. To correct this condition, the nurse should massage the fundus until it becomes firm and clots are expressed Complication of an epidural block include maternal hypotension Maternal bradycardia is commonly seen in the first six to ten days postpartum Elevation in temperature 24 hours after delivery is related to the exertion and dehydration of labor. It is not a cause for concern unless it goes above 100.4 degrees F and for 2 consecutive days after the first 24 hours. Loss of more than 500cc of blood at time of delivery or immediately thereafter indicates postpartum hemorrhage Uterine atony, laceration of the birth canal, retained placental fragment are some of the causes of postpartum bleeding. Subinvolution is the failure of the uterus to revert to pre-pregnant state through gradual reduction in size and placement. First day postpartum, the fundus should be found firm at midline. The fundus should be at the level of the umbilicus on the day of delivery and falls below the umbilicus by approximately one finger breadths per day until it has contracted into the pelvis by the 9 th or 10 th day An opoid antagonist used to counteract respiratory depression in the newborn is Naloxone (Narcan) Living spring notes 49
The newborn Apgar score is likely to be lowest when the mother has general anesthesia for childbirth The main disadvantage of home birth is lack of emergency equipment Prolactin stimulates the secretion of milk from the mammary glands. The best method for alleviating breast engorgement is to breast-feed the infant frequently. Wearing a support bra will also assist in controlling breast engorgement. Progressive uterine contraction is the definitive sign of true labor. The nurse should check the fetal heart first if the client has spontaneous rapture of the amniotic membrane.

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