Nursing care of the client with high risk labor and delivery Quizlet

Dysfunctional labor and problems with the 5 Ps (9) 21-2, 21-3

*21-2 Differentiate the four major abnormalities or problems associated with dysfunctional labor patterns, giving examples of each problem.
*21-3 Examine the nursing management for the woman with dysfunctional labor experiencing a problem with the powers, passenger, passageway, or psyche.

Preterm labor vs. prolonged pregnancy (10) 21-4, 21-5
*21-4 Devise a plan of care for the woman experiencing preterm labor.
*21-5 Relate the nursing assessment and management of the woman experiencing a prolonged pregnancy.

Obstetric emergencies, IUFD, and dystocia of labor (13) 21-1, 21-6

*21-1 Propose at least five risk factors associated with dystocia.

*21-6 Assess four obstetric emergencies that can complicate labor and birth, including appropriate management for each.

*Labor induction, augmentation, forceps, and vacuum-assisted birth (8) 21-7

*21-7 Compare and contrast the nursing management for the woman undergoing labor induction or augmentation, forceps- and vacuum-assisted birth.

*Cesarean birth, TOLAC, and VBAC (4) 21-8, 21-9

*21-8 Summarize the plan of care for a woman who is to undergo a cesarean birth.
21-9 Evaluate the key areas to be addressed when caring for a woman that undergoes a vaginal birth after cesarean (VBAC).???

Indication:
-Relaxes uterine muscles to stop irritability and contractions, to arrest uterine contractions for preterm labor (off-label use).
-Has been used in seizure prophylaxis and treatment of seizures in preeclamptic and eclamptic clients for almost 100 years.

Nursing Actions:
-Administer IV with a loading dose of 4-6 g over 15-30 minutes initially, and then maintain infusion at 1-4 g/hr.
-Assess vital signs and deep tendon reflexes (DTRs) hourly; report any hypotension or depressed or absent DTRs.
-Monitor level of consciousness; report any headache, blurred vision, dizziness, or altered level of consciousness.
-Perform continuous electronic fetal monitoring; report any decreased FHR variability, hypotonia, or respiratory depression.
-Monitor intake and output hourly; report any decrease in output (<30 mL/hr).
-Assess respiratory rate; report respiratory rate <12 breaths/min; auscultate lung sounds for evidence of pulmonary edema.
-Monitor for common maternal side effects, including flushing, nausea and vomiting, dry mouth, lethargy, blurred vision, and headache.
-Assess for nausea, vomiting, transient hypotension, and lethargy.
-Assess for signs and symptoms of magnesium toxicity, such as decreased level of consciousness, depressed respirations and DTRs, slurred speech, weakness, and respiratory and/or cardiac arrest.
-Have calcium gluconate readily available at the bedside to reverse magnesium toxicity.

Indication:
Inhibits prostaglandins, which stimulate contractions; inhibits uterine activity to arrest preterm labor.

Nursing Actions:
-Continuously assess vital signs, uterine activity, and FHR.
-Administer oral form with food to reduce gastrointestinal irritation.
-Do not give to women with peptic ulcer disease.
Schedule ultrasound to assess amniotic fluid volume and function of ductus arteriosus before initiating therapy; monitor for signs of maternal hemorrhage.
-Be alert for maternal adverse effects such as nausea and vomiting, heartburn, rash, prolonged bleeding time, oligohydramnios, and hypertension.
-Monitor for neonatal adverse effects, including constriction of ductus arteriosus, premature ductus closure, necrotizing enterocolitis, oligohydramnios, and pulmonary hypertension.
-Contraindicated in >32 weeks' gestations, fetal growth restriction, history of asthma, urticaria, or allergic-type reactions to aspirin or nonsteroidal antiinflammatory drugs.

This agent acts as a physiologic calcium antagonist and a general inhibitor of neurotransmission. Expect to administer it intravenously. Monitor the woman for nausea, vomiting, headache, weakness, hypotension, and cardiopulmonary arrest. Frequent monitoring of maternal respiratory effort and deep tendon reflexes is essential for early recognition of overdose. Because magnesium is exclusively excreted by the kidneys, adequate renal function is essential for safe administration. Assess the fetus for decreased FHR variability, drowsiness, and hypotonia. Magnesium has a wide margin of safety but is not more effective in delaying preterm birth as any other tocolytic agent. However, if administered prenatally, it is effective in helping women who develop preeclampsia and helps in fetal neuroprotection

Sudden shortness of breath

Sudden shortness of breath can be a sign of amniotic fluid embolism and requires emergent intervention. This can occur suddenly during labor or immediately after. The woman usually develops symptoms of acute respiratory distress, cyanosis, and hypotension. It must be reported to the care team so proper interventions may be taken. Other symptoms can include hypotension, cyanosis, hypoxemia, uterine atony, seizures, tachycardia, coagulation failure, DIC, and pulmonary edema.

What are the nursing care of the client experiencing labor and delivery process?

The nursing care plan for a client in labor includes providing information regarding labor and birth, providing comfort and pain relief measures, monitoring the client's vital signs and fetal heart rate, facilitating postpartum care, and preventing complications after birth.

When providing nursing care to a laboring patient which is the highest priority for the nurse?

labornclex.

What is an essential part of nursing care for the laboring woman?

Assessing and reassessing uterine activity is an important aspect providing nursing care in the laboring woman. As labor progresses from early to active, uterine contraction frequency, strength, and duration increases due to release of prostaglandins and endogenous oxytocin.

What nursing care should the nurse focus on during the first stage of labor quizlet?

1. What nursing care should the nurse focus on during the first stage of labor? RATIONALE: First-stage nursing care focuses on assessment of the client's vital signs, contractions, and cervical change, as well as assessment of the fetal well-being.