ob chapter 23 part 3_ amniofusion and shoulder dystocia Flashcards
What is an amnioinfusion?
The addition of sterile fluid into the uterus to supplement amniotic fluid and reduce cord compression.
What type of catheter is used for an amnioinfusion?
A sterile double-lumen catheter inserted through the cervix into the uterus.
How is the amnioinfusion fluid administered?
The catheter is attached to IV tubing, and warmed normal saline is rapidly infused.
How is the infusion rate determined?
The rate is adjusted to the least amount necessary to maintain an FHR pattern without variable decelerations.
What patient position is recommended during amnioinfusion?
Lateral recumbent position to prevent supine hypotension syndrome.
What infection control measure must be followed during an amnioinfusion?
Maintain strict aseptic technique.
What fetal and maternal monitoring is required during an amnioinfusion?
Continuous fetal heart rate (FHR) and contraction monitoring.
How often should the patient’s temperature be recorded?
Every hour to detect infection.
What is an important assessment related to fluid drainage?
Ensure there is constant vaginal drainage to prevent polyhydramnios.
What is shoulder dystocia?
A birth complication where the fetal head is born, but the shoulders are too broad to pass through the pelvic outlet.
Why is shoulder dystocia hazardous to the birthing parent?
It can cause vaginal or cervical tears.
Why is shoulder dystocia hazardous to the fetus?
The umbilical cord may be compressed between the fetal body and the bony pelvis, leading to oxygen deprivation.
What injuries can shoulder dystocia cause in the fetus?
Fractured clavicle or brachial plexus injury.
Why is shoulder dystocia becoming more common?
The weight and size of newborns are increasing.
What are the risk factors for shoulder dystocia?
Diabetes, multiparity, large-for-gestational-age (LGA) fetus, and postdate pregnancy.
When might shoulder dystocia be suspected?
If the second stage of labor is prolonged or there is arrest of descent.
What is the “turtle sign,” and what does it indicate?
When the fetal head moves past the perineum but then retracts; it suggests shoulder dystocia.
When is shoulder dystocia usually identified?
After the fetal head is born and the anterior shoulder becomes locked under the symphysis pubis.
What are the two main procedures to resolve shoulder dystocia?
McRoberts maneuver and suprapubic pressure.
What is the McRoberts maneuver?
The patient is assisted to deeply flex their thighs toward their abdomen and then rotate them laterally into a wide V to widen the pelvic outlet.
How does the McRoberts maneuver help with shoulder dystocia?
It widens the pelvic outlet, which may allow the anterior shoulder to be born.
What is suprapubic pressure?
Downward and lateral pressure applied just above the pubic bone to dislodge and rotate the fetal shoulder.
Where should the nurse stand when applying suprapubic pressure?
On the side closest to the fetal back.
How does suprapubic pressure help resolve shoulder dystocia?
It helps rotate the fetal shoulder and free it from beneath the symphysis pubis.
