Complications of Birth Blue print

Question 1

Uterine rupture
S/S

Answer 1

Life-threatening for mom and baby

Pale skin
Diaphoretic (sweating heavily)
Abdominal pain
Shock (high HR, low BP)

Question 2

If we see vertical incision on lower abdomen from previous c-section.
What do we concern about?

Answer 2

Uterine rupture

Question 3

Uterine rupture
Nursing intervention

Answer 3

Stay with patient
IV fluids, blood
give O2
Immediately Call
Prepare C section

Question 4

Uterine rupture
Causes

Answer 4

Previous C-section
Multiple gestation
Macrosomia baby

Question 5

Prolapsed Cord
Causes

Answer 5

MEDICAL EMERGENCY
Rupture of membranes when fetal head is unengaged

Question 6

Prolapsed Cord
S/S

Answer 6

Variable decelerations of FHR
-compression of the umbilical cord

Late decelerations of FHR
-Uteroplacental insufficiency,

Question 7

Prolapsed Cord
Nursing intervention

Answer 7

Assess FHR immediately after membrane rupture
Push presenting part off cord
Or place pt knee-chest position
Prepare for immediate delivery

Question 8

Shoulder dystocia
Nursing action

Answer 8

Watch for turtle sing
Monitor FHR
Document time and events
Apply McRoberts maneuvers

Question 9

Shoulder dystocia
Risk for mom and baby

Answer 9

Mom
-Hemorrhage
Baby
-Clavicle broken

Question 10

Chorioamnionitis
Causes

Answer 10

Frequent vaginal examinations
Prolonged rupture of membranes

Bacteria commonly found in the vagina
Infection of ammonitic cavity surrounding the fetus

Question 11

Chorioamnionitis
-S/S
Mom and baby

Answer 11

Mom
-Fever
-Uterine tenderness
-Foul odor of amniotic fluid

Baby
-Fetal tachycardia

Question 12

C-section
Nursing action BEFORE

Answer 12

NPO
Ensure IV access
Place indwelling catheter
Administer pre-op meds

Question 13

C-section
Nursing action AFTER

Answer 13

Monitor bleeding!!
Monitor fundal tone!!
Manage pain and nausea!!

Monitor lochia
Monitor VS
Monitor I&O
Monitor return of sensation

Question 14

Precipitous delivery?

Answer 14

Birth that occur within 3hr
From start to finish
Maybe hypertonic labor pattern

Question 15

Precipitous delivery
Risk mom and baby?

Answer 15

Mom
Perineal trauma
Painful(contraction so strong and fast)
More risk for bleeding

Baby
Stress/ meconium
Bruising to head

Question 16

Precipitous delivery
Nursing action

Answer 16

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

Question 17

Why is oxytocin given in labor?

Answer 17

Improve contractions during labor
Reduce bleeding after childbirth

FHR monitor need to continuous

Question 18

If baby’s head is not engaged but membrane rapture, what is concern?

Answer 18

Cord prolapse

Question 19

What this mean?

Answer 19

Late decelerations
=decreased placental perfusion

Question 20

What can we do when baby has poor perfusion?

Answer 20

Turning off the Pitocin!
Help the patient roll to her side
Give O2 by face mask
IV bolus

Question 21

C-section
can lead to poor perfusion, why?

Answer 21

Epidurals dec mom’s BP
= poor perfusion
IV fluid!!!

Question 22

Operative vaginal delivery
Nursing action

Answer 22

Empty bladder
Monitor the FHR

Question 23

Hypertonic labor risk for what to fetal?

Answer 23

Prolonged pressure on fetal head may lead to cephalohematoma
-fetal head ruptures small blood vessels

Question 24

What terbutaline for?

Answer 24

Preventing and slow contraction
Relax smooth muscle and inhibits uterine contractions

Question 25

The S/S fetal destress

Answer 25

FHR is anything NOT
Baseline of 110-160
Variability is present
Accelerations occur
Decelerations are not occurring

Question 26

a) Hypertonic labor
b) Hypotonic labor

Answer 26

a) More than 5 contractions in 10 minutes window
b) Less than 2-3 contractions in 10 minutes window

Question 27

a) Hypertonic labor
b) Hypotonic labor

Nursing action

Answer 27

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