High Risk Labor And Birth (Ch. 10) Flashcards
Define dystocia
difficult labor characterized by abnormally slow labor progress
Hypertonic uterine dysfunction
has contractions that are painful but don’t effect dilation and effacement of cervix
Treatment for Hypertonic uterine dysfunction
Promote rest and quiet environments
- Nap
- Administer pain medications
- Warm shower
- Hydrate
Hypotonic uterine dysfunction
Progresses like normal then gets worse and weaker
Interventions for Hypertonic uterine dysfunction
- Oxytocin
- Amniotomy
- C section
How can you stimulate uterine activity?
- Ambulation & position changes
- Hydrate IV or PO due to dehydration
- Administer IV fluids to increase volume, correct maternal hypotension, and improve placental perfusion
What medication can cause problems during pushing?
Epidural because the women might not feel the urge to push
How do you treat issues that happen during pushing?
- Oxytocin
- Assist birth with vacuum or forceps
- Perform C section
What must the nurse do with a grand multiparty?
Stay with them at all time due to increase risk for precipitous labor and birth
What is induction of labor?
Deliberate stimulation of UC before the onset of spontaneous labor to facilitate a vaginal delivery
When should you not use oxytocin?
- Pervious classical uterine scar
- Placenta previa/ abruptions
- Abnormal fetal position
- Active herpes
- Pelvic abnormalities
What is the primary complication with giving oxytocin?
Tachysystole leading to category 2 or 3 FHR pattern
Can you restart oxytocin if tachysystole has occurred?
Yes once FHR is normal, UC are normal then resume at no more than half the rate the caused it to start
What does the bishop score assess?
Cervical status
What score do you want for Bishop test?
greater than 8 is great means a vaginal delivery with induction of labor
What is amniotomy?
artificial rupture of membranes
Nursing actions after an amniotomy?
- Assess FHR
- Assess color, amount of amniotic fluid
- Assess maternal temp q4h for S/S of infection
What is external cephalic version (ECV)?
Rotated from breech to correct way
What do you have to give with (ECV)?
Partental tocolysis (beta agonists)
What is labor augmentation?
stimulation of ineffective UC
What is the maximum attempt for vacuum- assisted delivery?
3 attempts for 15 minutes
What could indicate forceps assisted delivery?
High level of regional anesthesia that inhibits pushing
why do you insert a catheter with a forceps assisted delivery?
Decrease risk for bladder trauma, and increase room for fetal head and forceps
