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NURSING 351 - OB exam 2 Study Guide

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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 indu ... ction 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 [Show More]

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