birth risk 3

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  1. Amnioinfusion
    • birth related procedures
    • not enough fluid thats why we give this.
    • a technique in which a volume of warmed sterile normal saline or ringer's lactated solution is introduced into uterus thru an IUPC to incr volume of fluid
    • contraindicated for vag bleedings, previa, hypotonicity
    • use IUPC- cord alongside baby's head
    • a bolus to be infused on a pump for 20-30mins 200-500ml
    • monitor FHR, and mom's belly closely bc if u gave her too much fluid u could rupture her uterus
    • can use for thick meconium so baby's don't breath in this
  2. Amnioinfusion indication
    • Indications:
    • severe variable decels due to cord compression
    • oligohydraminos due to placental insufficiency
    • postmaturity or rupture of membranes
    • preterm labor with preterm rupture of membranes
    • thick meconium- plugs up baby alveoli if aspiration...doesnt allow for o2 exchange
  3. amnioinfusion management
    • explain need of procedure, what it involves, and how it would solve the problem
    • inform mom she would need to remain on bedrest during procedure
    • assess the mother's VS and associated discomfort level
    • monitor FHR
    • maintain intake and output
    • IUPC is good to monitor intensity of contraction and also switch over if needed
  4. Forceps or vacuum assisted birth
    forceps: stainless steel instruments similar to tonges with rounded edges that fit around the fetus head

    Vacuum extractor: cup shaped instrument attached to a suction pump used for extraction of the fetal head- guiding fetus head to come out...doesnt suction baby out
  5. forceps and vacuum indication risk
    • Application of traction to fetal head
    • Indications: prolonged 2nd stage of labor, non reassuring fetal heart rate pattern, failure of presenting part to fully rotate and descend, limited sensation or inability to push effectively, pressume fetal jeopardy or fetal distress, maternal heart disease, acute pulmonary edema, intrapartum infection, mom fatigue, infection
    • risk of tissue trauma to mom and newborn
    • Prevention is key identify early on the baby will give us trouble we can do intervention
  6. Cesarean Birth
    • delivery of fetus thru an incision in the abdomen and uterus
    • a classic (vertical) or low transverse incision may be used

    • classical (alters integrity of uterus) or transverse (preserve uterus) incision
    • major surgical procedure with accompanying risk
    • nursing assessment: hx and physical examination mom and fetus. why are doing this procedure
    • nursing management
    • better to schedule when mom is due
    • classical during emergency
  7. C-section pre op care
    • preop teaching (i.e. IS, deep breathing, exercises and leg excercises,splint incision
    • abd prep- shave
    • inserting an indwelling (foley) catheter
    • initiate IV line, admins IV fluids bolus
    • admins any pre op meds as order, document time admins and reaction
    • transport to operative room
  8. c-section post op
    • VS, lochia flow q 15 mins for the 1st hour then q 30mins for the next hr, and then q 4 hours if stable
    • inspect abd dressing and document description
    • assess fundus
    • check IV line
    • monitor I&O q 4 hrs initially and then q 8 hours
    • encourage the woman to cough, deep breath use of spirometer q 2 hrs (most pt get duramorph)
  9. Vaginal birth after c-section
    • a woman who gives birth naturally after having previous c-section
    • controversy- bc of previous incision in uterus
    • contraindications
    • - classical uterine incision, prior transfundal uterine surgery myomectomy, uterine scar other than low transverse c-scar
    • - use of cerical ripening agents
  10. Vag birth after c-section2
    • special areas of focus (good assessments), consent document, surveillance and readiness for emergency
    • nurses as advocates for clients, expertise in reading fetal monitoring tracings to identify nonreassuring pattern and instituting measures for emergency delivery
Card Set:
birth risk 3
2015-03-07 03:19:44

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