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DIANNA S. GERONA, RN
TRIAL LABOR
Done to determine whether labor can progress normally Indication:
Borderline inlet measurement but good fetal lie and position
Nursing management:
Monitor FHR and uterine contractions Emptying of the bladder Prepare for CS
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Nursing Management:
Tocolytic agent administration as ordered Record UTZ and FHR continuously
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Labor Augmentation
Assisting labor that has started spontaneously to be more effective.
DIANNA S. GERONA, RN
DIANNA S. GERONA, RN
Oxytocin Administration
Nursing Management:
Monitor uterine contractions, FHR, and VS q 15 mins. Watch out for signs of water intoxication and tonic uterine contractions
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INSTRUMENTAL DELIVERIES
DIANNA S. GERONA, RN
FORCEPS DELIVERY
Indications:
The woman is unable to push with contractions Spinal anesthesia or spinal cord injury Cessation of progress in the 2nd stage of labor Abnormal fetal position
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FORCEPS DELIVERY
2 TYPES: Low forceps birth
Fetal head at +2 station
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FORCEPS DELIVERY
Before forceps are applied:
Ruptured membranes No CPD Fully dilated Cervix Empty bladder
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FORCEPS DELIVERY
Complications: Urinary stress incontinence Birth trauma
Facial paralysis Subdural hematoma Erythemetous mark on the babys cheek
Cord compression
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VACUUM EXTRACTION
For a fetus that is positioned far down
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VACUUM EXTRACTION
Advantage: Fewer lacerations at the birth canal Disadvantage: Caput noticeable until 7
days
Contraindications:
Pre term infants
Previous scalp blood sampling
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CESARIAN BIRTH
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CESARIAN BIRTH DELIVERY OF THE BABY THROUGH AN ABDOMINAL & UTERINE INCISION.
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INDICATIONS: 1.FETAL DISTRESS 2. BREECH PRESENTATION 3. DYSTOCIA 4. CPD 5. PRIOR CESARIAN SURGERY 6. CORD PROLAPSE 7. ABRUPTIO PLACENTA 8. PLACENTA PREVIA
COMPLICATIONS:
1.INFECTIONS
2. HEMORRHAGE
3. BLOOD CLOTS
4. SURGICAL INJURY
FETUS.
TYPES:
3. LESS INCIDENCE OF POSTOPERATIVE COMPLICATIONS: INFECTION, ADHESION OF BOWEL TO THE INCISIONAL LINE, INTESTINAL OBSTRUCTION.
4. ALLOWS A VAGINAL DELIVERY AFTER A PREVIOUS CESARIAN SECTION.(VBAC)
DISADVANTAGES:
2. CLASSICAL TYPE - A VERTICAL INCISION IS MADE DIRECTLY INTO THE WALLS OF THE CORPUS, WHICH IS THE MOST CONTRACTILE PORTION.
ADVANTAGES:
1.EASIEST & QUICKEST INCISION TO PERFORM 2. RAPID EXTRACTION OF FETUS CAN BE DONE.
DISADVANTAGES:
Hematoma
Bluish or purple discoloration of SQ tissue of vagina or perineum. Mgt: cold compress every 30 minutes with rest period of 30 minutes for 24 hrs incision on site, scraping & suturing
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Sub Involution
Management: D&C Proper position - prone Cold compress to prevent bleeding Mefenamic acid
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DIC
Disseminated Intravascular Coagulopathy. Management:
hysterectomy if with abruption placenta Heparin Platelet concentrate cryoprecipitate or fresh frozen plasma
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Puerperal Infection
General signs of inflammation: calor (heat), rubor (red), dolor (pain) tumor(swelling) Purulent discharges Fever Supportive care CBR Hydration TSB Cold compress
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Mastitis
Inflammation of the mammary gland Signs & Symptoms Fever Chils Malaise Flu like symptoms
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Management
Antibiotic therapy for 7 to 10 days May continue with BF unless there is an open abcess formation If with abcess, use pump to evacuate milk until it heals May continue to breastfeed on the unaffected side
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MAnagement
Bed rest Anticoagulants Antibiotics Anlagesics Moist heat applications Never massage affected area Elevation of affected extremity
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Postpartum Depression
A feeling of overwhelming feeling of sadness which cannot be accounted for Symptoms:
Excessive anxiety Irritability Fatigue Loss of apetite Feelings of worthlessness
Management:
Psychological counseling Encourage talking about her feelings
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Postpartum Psychosis
Mental state which involves a loss of contact with reality May result from unrecognized and untreated depression. Symptoms:
Agitation Euphoria Delusions Disorganized behavior
Management:
Psychiatric counseling Anti-psychotic drugs
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