Anticoagulation therapy is required for women experiencing a DVT during

Anticoagulation therapy is required for women

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Anticoagulation therapy is required for women experiencing a DVT during pregnancy with heparin. Treatment of PE is to stabilize a woman with a lifethreatening PE and transfer to ICU. Thromboembolitic therapy and catheter or surgical embolectomy may be done. Nursing Actions Manage pain, administering pain medication as needed. Teach woman how to administer heparin SQ to her abdomen. Instruct woman to report side effects such as bleeding gums, nosebleeds, easy bruising, or excessive trauma at injection sites. Hypertonic Uterine Dysfunction Defined as uncoordinated uterine activity o Signs/symptoms/findings on fetal heart rate tracing Decreased placental perfusion Frequent, painful contractions with inadequate uterine relaxation between contractions with little cervical change Possible Category 2 FHR tracing Painful, frequent UCs with inadequate uterine relaxation between UCs with little cervical changes (Fig. 10-1B). May be Category II (indeterminate) or Category III (abnormal) fetal heart rate (FHR) related to prolonged labor and inadequate uterine relaxation o Problems/complications with delivery o Nursing interventions: Promoting rest to break pattern Letting the woman sleep for several hours, may wake up to normal labor pattern Administration of pain medication Warm shower or bathtub Quiet environment PO or IV hydration Continuous fetal monitoring Hypotonic Uterine Dysfunction The strength of contractions is inefficient (<25 mm Hg) in promoting cervical dilation & effacement o Signs/symptoms/findings on fetal heart rate tracing Decreased frequency, strength, and duration of UCs Little or no cervical change Less than 0.5 cm/hr progress in cervical dilation for a primiparous woman in active labor Less than 1.0 cm/hr progress in cervical dilation for a multiparous woman in active labor Increased fear and anxiety levels o Problems/complications with delivery Risk for maternal exhaustion and infection Risk for fetal intolerance to labor and distress o Interventions Ambulate or change position for comfort and to help labor progress IV hydration (D5LR) Augment labor with oxytocin (Pitocin) Prepare for provider to perform amniotomy
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Prepare for c-section for fetal distress or when interventions are ineffective Maternal Obesity o BMI 30 or greater o Risks for pregnancy Pre-eclampsia Gestational diabetes Thrombosis Miscarriage Post-partum infection UTI C-section delivery Pregnancy complications o Induction of Labor o Indications o Contraindications Placentia previa or Vasa previa Cord compression Abnormal fetal lie / presentation Chephalopelvic disproportion b/c of malpresentation or abnormal pelvic bone structure Active genital herpes infection Invasive cervical carcinoma Hypersesitivity to cvervical ripening agents Previous uterine rupture o Bishop’s score >8 = good chances for vaginal delivery.
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