Complications of Birth Blue print Flashcards
Uterine rupture
S/S
Life-threatening for mom and baby
Pale skin
Diaphoretic (sweating heavily)
Abdominal pain
Shock (high HR, low BP)
If we see vertical incision on lower abdomen from previous c-section.
What do we concern about?
Uterine rupture
Uterine rupture
Nursing intervention
Stay with patient
IV fluids, blood
give O2
Immediately Call
Prepare C section
Uterine rupture
Causes
Previous C-section
Multiple gestation
Macrosomia baby
Prolapsed Cord
Causes
MEDICAL EMERGENCY
Rupture of membranes when fetal head is unengaged
Prolapsed Cord
S/S
Variable decelerations of FHR
-compression of the umbilical cord
Late decelerations of FHR
-Uteroplacental insufficiency,
Prolapsed Cord
Nursing intervention
Assess FHR immediately after membrane rupture
Push presenting part off cord
Or place pt knee-chest position
Prepare for immediate delivery
Shoulder dystocia
Nursing action
Watch for turtle sing
Monitor FHR
Document time and events
Apply McRoberts maneuvers
Shoulder dystocia
Risk for mom and baby
Mom
-Hemorrhage
Baby
-Clavicle broken
Chorioamnionitis
Causes
Frequent vaginal examinations
Prolonged rupture of membranes
Bacteria commonly found in the vagina
Infection of ammonitic cavity surrounding the fetus
Chorioamnionitis
-S/S
Mom and baby
Mom
-Fever
-Uterine tenderness
-Foul odor of amniotic fluid
Baby
-Fetal tachycardia
C-section
Nursing action BEFORE
NPO
Ensure IV access
Place indwelling catheter
Administer pre-op meds
C-section
Nursing action AFTER
Monitor bleeding!!
Monitor fundal tone!!
Manage pain and nausea!!
Monitor lochia
Monitor VS
Monitor I&O
Monitor return of sensation
Precipitous delivery?
Birth that occur within 3hr
From start to finish
Maybe hypertonic labor pattern
Precipitous delivery
Risk mom and baby?
Mom
Perineal trauma
Painful(contraction so strong and fast)
More risk for bleeding
Baby
Stress/ meconium
Bruising to head
Precipitous delivery
Nursing action
Stay with the patient
Make sure to patient come down
with assist breathing
DO NOT stop delivery but apply gentle pressure to fetal head to prevent it from tearing perineum
Suction nose and mouth before deliver if there is a time
Why is oxytocin given in labor?
Improve contractions during labor
Reduce bleeding after childbirth
FHR monitor need to continuous
If baby’s head is not engaged but membrane rapture, what is concern?
Cord prolapse
What this mean?
Late decelerations
=decreased placental perfusion
What can we do when baby has poor perfusion?
Turning off the Pitocin!
Help the patient roll to her side
Give O2 by face mask
IV bolus
C-section
can lead to poor perfusion, why?
Epidurals dec mom’s BP
= poor perfusion
IV fluid!!!
Operative vaginal delivery
Nursing action
Empty bladder
Monitor the FHR
Hypertonic labor risk for what to fetal?
Prolonged pressure on fetal head may lead to cephalohematoma
-fetal head ruptures small blood vessels
What terbutaline for?
Preventing and slow contraction
Relax smooth muscle and inhibits uterine contractions
The S/S fetal destress
FHR is anything NOT
Baseline of 110-160
Variability is present
Accelerations occur
Decelerations are not occurring
a) Hypertonic labor
b) Hypotonic labor
a) More than 5 contractions in 10 minutes window
b) Less than 2-3 contractions in 10 minutes window
a) Hypertonic labor
b) Hypotonic labor
Nursing action
a) Stop Oxytocin
Terbutaline is for preventing and slow\contractions
b) Start oxytocin
Rupture membrane
Encourage voiding every 2hr to rule out bladder distention
the stretching of the bladder with water
