Nursing Care During Labor & Birth- Chapter 15
Learning Objectives/Study Guide
Discuss indications, maternal & fetal risk factors and nursing care for the following:
- Methods for labor induction and cervical ripen
...
Nursing Care During Labor & Birth- Chapter 15
Learning Objectives/Study Guide
Discuss indications, maternal & fetal risk factors and nursing care for the following:
- Methods for labor induction and cervical ripening
- Instrument assisted birth
- Episiotomy
- Cesarean section
Amniotomy
Artificial rupture of amniotic sac- labor augmentation
- Usually performed with induction or augmentation of labor
- To allow for internal electronic fetal monitoring
- Performed with amnihook (only used and performed by provider)
- Can happen with FSE
Risks:
- Prolapse of umbilical cord
Cord can easily be compressed between fetal presenting part and pelvis
Obstructed blood flow to and from placenta, decreased gas exchange
- Infection- if she still doesn’t deliver prolonged rupture
Bacteria from vagina to cervix with rupture and repeated cervical exams
No barrier = vaginal organisms have free access to uterine cavity chorioamnionitis
(inflammation of amniotic sac, usually caused by bacterial and viral infections)
Risk increases as time between rupture and birth is prolonged
- Abruptio Placentae
Increased incidence with hydramnios and uterine distention. Uterus shrinks down with exodus of
fluid and the placenta no longer fits the implantation site separation
Bloody fluid may show, may be internal- hard, painful abdomen
Large area of separation significantly decreases fetal oxygenation, nutrition, and waste disposal
Safety & Nursing Considerations
- Obtain baseline information
Assess FHR (priority) for reassuring patterns before amniotomy- minimum of 20-30min needed for
adequate baseline
Monitor Fetal Heart Rate- make sure it doesn’t turn into fetal brad
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