Diagnostic Therapeutic Procedures If mom pushes for 2 hours the baby may not

Diagnostic therapeutic procedures if mom pushes for 2

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Diagnostic & Therapeutic Procedures If mom pushes for >2 hours the baby may not fit Ultrasound Amniotomy Oxytocin infusion Vacuum-assisted birth C-section o Patient-centered care Nursing care Assist o Step stool McRobert’s maneuver Pushing legs back Pushing down suprapubic area
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Pops shoulders out Suprapubic pressure Encourage bladder emptying Encourage position changes Encourage ambulation Monitor FHR Maintain hydration Baby may break clavicle Medications Analgesics Oxytocin o Strengthens uterine contractions
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ROA Right occipitoanterior LOA Left occipitoanterior BUBBLE – important to assessments on mom Breast Uterus Bowels Bladder Lochia o How much on pad o Fundal checks Episiotomy (if had) Lower Extremity Swelling Emotional Status
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Amniotomy: Nursing interventions during and after, advantages of performing Artificial breaking of water Nursing Interventions o Check fetal heart tones Risk for cord prolapse If cord prolapses HR will drop fast o Check fluid color Clear or meconium stain Infection risk Advantages o helps increase pressure on cervix to cause dilation o More natural way to induce labor Cervical readiness: why important for labor induction, bishop score (What is it measuring) o Determines readiness of labor & determines likelihood natural birth Most important criteria for successful induction o If not a high enough bishop score, induction may not work & may need a c-section o Where baby is located in relation to ischial spine o Don’t want to induce labor too soon Twins: vaginal vs. c/s delivery C-section not always indicated but usually depending on position of baby C/S: Medical indications for, maternal positioning during Supine w/ wedge Indication o Twins o Big baby o Breech o Cord prolapses o Not progressing o Pre-eclampsia o Herpes / HIV Pitocin/Oxytocin: what is it, what does it do, Why given to induce, why given after delivery, what to watch for while patient is receiving Pitocin in labor, when to stop Pitocin in labor What does it do?
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o Stimulates contractions to induce labor Give in small increments during labor Risk for uterine rupture if given too fast Why given after delivery? o Helps uterus clamp down Limits bleeding What to monitor for while in labor? o Uterine rupture If given too fast o Too fast of contractions Decreases fetal oxygenation Monitor FHR / vitals When to stop giving in labor? o Contractions <2 min apart Prolapsed cord: nursing interventions o o Water breaks & cord slips past baby o Assessment Risk factors Breech or transverse position Rupture of amniotic membranes Small for gestational age fetus Unusually long umbilical cord Multifetal pregnancy Unengaged presenting part Hydramnios or polyhydramnios Expected findings Visualization or palpation of umbilical cord protruding
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