Postpartum Complications
Intrapartum Terms
Intrapartum Terms Continue
Nursing Interventions Intrapartum
MISC.
100
inflammation of breast tissue often due to infection, typically happens in the first 12 weeks after birth
what are some risks?
what are some interventions?
Mastitis
**Note: flu-like symptoms, painful, red/swollen area of the breast
Risks = incomplete emptying of the breast, tight bras
Interventions = antbiotics (PRIMARY), proper breastfeeding - every 2-3 hrs, warm compress, 2500-3000mL of water a day
100
occur when the baby's head or body is too large to pass through the mother's pelvis during childbirh - mismatch between size of baby and size of mother's pelvis (makes it difficult or impossible)
cephalopelvic disproportion (CPD)
100
occurs when labor begins after the 20th week but before the 37th week of pregnancy - struggle with breathing, temperature regulation, increased risk for long term developmental issues
Preterm Labor
100
Cephalopelvic Disproportion
monitor labor progress
fetal heart rate --> detect signs of fetal distress, potential need for c-section
health care team may allow a trial of labor for vaginal delivery, but if failed c-section is performed
100
which position is the most wanted in delivery?
LOA
200
bacterial infection of the genital tract following childbirth - after birth, after water breaks --> 42 days postpartum
what are the risks?
what are the interventions?
Peurperal Infection
**note: common infections = endometriosis, UTI, mastitis, septic pelvic thrombophlebitis
Risks = C-section, prolonged rupture of membranes, poor hygeine, tears during delivery, excessive bleeding weakens immune
Interventions = antibiotics, hygeine educate, perineal care
200
happens when normal progress of labor does not occur (cervical dilation and effacement) - it may involve difficult or prolonged labor
dysfunctional labor
200
refers to the rupture of the amniotic sac BEFORE the onset of labor
premature rupture of membranes (PROM)
Do not get confused with preterm rupture of labor PPRM --> occuring before 37 weeks of gestation
200
Hypotonic
does not usually lead to fetal hypoxia, so properly manage her pain, amniotomy, oxytocin
we want to encourage upright position like walking (promote stronger contractions)
rehydrating with oral fluids and IV
200
TRUE OR FALSE
false
a mother wants to avoid taking opioids close to birth to prevent respiratory distress on the fetus
300
failure of uterus to return to its pre-pregnancy size - 6 weeks it should be fully back to pre-pregnancy size
What are the signs?
What is the treatment?
What is the cause?
subinvolution
signs = prolonged lochia, heavy bleeding, irregular bleeding, back/pelvic pain, feeling unwell
treatment = methylergonovine - helps uterus contract and shrink
cause = placenta retained and pelvic infection
300
occurs when contractions are coordinated but too weak to effectively dilate the cervix and advance labor, the contractions are infrequent, brief, and easy to indent on the abdomen even at their peak - typically happens during the active phase of labor after 4cm of dilation - where progress is expected to be quickened
Hypotonic Contractions
300
baby's head is down but the back of the head is facing the mother's back
Occiput Posterior
300
Hypertonic
pain relief, warm showers, bath, systemic analgesics or an epidural, amniotomy, tocolytics - reduce uterine contractions and lower the high resting tone
**NOTE oxytocin is not normally given because it can increase already high uterine tones
300
a procedure to manually turn a fetus from a breech or transverse position to a vertex (head-down) position
Monitor FHR before, during and after
Administer tocolytics
Version (External Cepahlic Version, ECV)
- it can help avoid c-section, but fetal well being must be monitored closely, as the procedure may cause distress
400
uterine does not contract properly after birth, leading to lack of uterine muscle tone, leading to hemorrhage
what is the cause?
what is the treatment?
what are the signs?
uterine atony
causes = overdistended uterus, prolonged labor, rapid labor
treatment = massage uterus, oxytocin, monitor bleeding and clots
signs = excessive bleeding, boggy uterus, rapid drop in BP, signs of shock
400
when the contractions during labor are uncoordinated and erratic and occur with abnoraml frequency, duration and intensity - painful contractions, do not lead to effective cervical dilation
Hypertonic Contractions
400
baby head is delivered, shoulders stuck on mom's pelvis = preventing baby from being born, unpredictable
shoulder dystocia
400
Malpresentation
Leopold's Maneuver
Vaginal Examination - assess fundal height, ultrasound
Educate the patient, Emotional support
ECV, around 36-37 weeks
Prepare for c-section if needed
400
What are the seven cardinal movements?
1. descent
- enters the pelvic inlet and moves toward ischial spines at -5cm
2. engagement
- 0 station
- can happen prior to labor
3. flexion of fetal head
4. internal rotation of the head
- occurs in birth canal
- long axis of fetal head is now aligned with the long axis of the pelvis outlet, followed by rotation of shoulders
5. extension of the fetal head
- beneath mothers pubicbone
6. external rotation of fetal head
- restitution
- slightly align with shoulders
7. expulsion
500
blood loss more than 1000mL in C-section and 500mL in vaginal delivery that causes hypovolemia within 24 hours after birth (early), 24 hours - 12 weeks (late)
what are the causes?
What are the risks?
what are the interventions?
Postpartum Hemorrhage
*NOTE: leading cause of maternal death worldwide
Cause = uterine atony, trauma to birth canal, hematomas, retained placental fragments
Risks = overdistended uterus, prolonged labor, uterine atony, obesity
Interventions = fundal massage, uterotonics, monitor vital signs, full bladder makes it harder for uterus to contract EMPTY IT
500
happens when the baby is NOT in the head down position (cephalic) for delivery
Malpresentation
**NOTE: types --> breech: frank breech, complete breech, footling breech, transverse lie, oblique lie, and face or brow presentation
500
cord slips down through the cervix and into the birth canal after the membranes ruptured. May compress between baby and uterus - causing hypoxia and distress
Prolapse of the Umbilical Cord
500
Preterm labor
magnesium sulfate, nifedipine (tocolytics) - stop uterine contractins and delay birth
betamethasone (corticosteroids) - develop fetal lung and reduce resp distress
lifestyle changes
early identification
500
what medication is given when premature rupture of membranes occurs
prophylactic antibiotics to prevent infection
**ampicillin - 2g IV ev ery 6 hours followed by amoxicillin or erythromycin