ch 7 nursing care during labor

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ch 7 nursing care during labor
2015-01-26 22:24:42
nursing care labor maternity
eastern suffolk boces
nusing care during labor
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  1. in hospital birthing room
    woman stays in the same room for abor, delvery and recovery (LDR room)
  2. freestanding centers
    • out of hospital birthing facility
    • combines home like environment with a short stay ambulatory health facility with access to in hospital obstetric and newborn care
  3. community based nurse-midwife usually manages home births, woman is in familiar, comfortable surroundings and less epensive
    home birth
  4. contractions increase in ______, _______ and intensity
    first child:
    second or later:
    • pattern of increasing frequency, duration and intensity
    • first child: comes when contractions have ben regular ( q 5 minutes) for 1 hr
    • second or later child: comes when contractions are and 10 minutes apart for one hour
  5. reasons to go to the hospital
    • ruptured membranes
    • bleeding other than bloody show, bleeding that is not mixed w/ mucus
    • any other concern
  6. nursing care of woman in FALSE labor
    • fetal monitoring
    • woman can walk when not being monitored
  7. 3 priorities the nurses data collection should focus on?
    • condition of mother and fetus
    • whether birth is imminent
    • labor appears to be uneventful
  8. WARNING SIGNS: Potential complications
    • maternal fever greater than 38 degrees F, 100.4 degrees F
    • contractions longer than 90 seconds
    • contractions less than 2 min apart
    • meconium stained amniotic fluid
    • foul smelling vaginal discharge
    • excessive bleeding and hypotension
    • fetal bradycardia or tachycardia
    • loss of baseline variability on fetal monitor
    • FHR <110 or >160 bpm
  9. when should fetal heart rate be taken
    • -immeadiately after ROM
    • -vaginal exam
    • -administration of meds
    • -notation of abnormal fetal activity
    • -noninvasive: reduces the chance of infection
    • -can be done at any time (before cervix is dialted and & amniotic membrane ruptured
    • -tracing gives permanent record
    • -uterine ¬†contraction intensity is not measurable
    • -may decrease personal contact with staff
    • -movement of woman may require frequent repositioning of transducers
    • -obesity and fetal position affect the quality of recordong
  12. what are accelerations
  13. maternal problems that must be reported in the 4th stage
    • -rising pulse rate and falling bp and decreasing urine output
    • -soft, boggy uterus
    • -lochia exceeding one pad per hour
  14. cause of rising pulse rate and falling bp and decreasing urine output (maternal problem in 4th stage)
    imminent hypovolemic shock
  15. cause of soft boggy uterus
    poorly contracted uterus, increasing the risk of hemmorrhage
  16. cause of lochia exceeding one pad per hour
    possible hemmorrhage
  17. cause of high, displaced uterine fundus
    full bladder ( can interfere with uterine contraction)