Complications in Labor
Risk Factors for DIC
Fetal Demise
Severe Preeclampsia
HELLP Syndrome
Retained Placenta
Shoulder Dystocia & Nursing Interventions
Call for Help
Evaluate for Episiotomy
Legs: McRobert's Position
External Pressure (Suprapubic)
Enter: Rotational Maneuvers
Remove the Posterior Arm
Roll the patient to her hands and needs
Signs of a Good "Infant Latch"
The infant's nose, mouth, and chin are touching the breast.
Swallowing is noted
Firm tugging at the breast
Assessment Findings Associated with Postpartum Hemorrhage
Elevated temp., elevated heart rate, decreased blood pressure, pale and clammy skin.
A 10% decrease in hematocrit from prebirth to postbirth
Assessment Findings Associated with Cephalopelvic Disproportion (CPD)
Fetus not engaged in the pelvis
Caput
Prolonged second stage of labor
Risk Factors & Complications Associated with Shoulder Dystocia
Maternal pelvic abnormalities, history of shoulder dystocia, obesity, diabetes, short stature, prolonged labor, post-date pregnancy
Laceration and Infection (maternal)
Fractured clavicle (infant)
Perineal Care Instructions
Warm Sitz Bath
Wash with Mild Soap every 24 hours
Report foul odor, increased redness, heat, or pain
Use your peri bottle after voiding
Ice as needed for swelling
Infant Security
Be sure to check the armbands/bracelets each time
Labor Dystocia
Difficult labor characterized by abnormally slow labor progression with no change in cervical dilation.
Nursing Interventions for a Prolapsed Umbilical Cord
Request immediate assistance and relieve occlusion by lifting the presenting part off the cord
Regional Anesthesia - Nursing Interventions
Monitor BP and assess sensation in the lower extremities.
Baby Blues
Wide range of emotions during the first two week postpartum period. Caused by a shift in hormone levels.
Magnesium Sulfate Toxicity - Nursing Interventions
Stop the Infusion
Prepare to administer Calcium Gluconate
Prepare to provide ventilatory support
Notify the MD
Tachysystole
More than 5 uterine contractions in a ten min. period over a 30min window. Does not allow adequate resting time between contractions to promote fetal oxygenation.
Fundal Massage - Nursing Interventions
Support the Lower Uterine Segment to prevent uterine inversion
If the fundus is above the umbilicus and displaced make sure the bladder is emptied
Risk Factor Associated with Cesarean Delivery
Pulmonary Embolism - Sudden onset of shortness of breath and chest pain.
Uterine Rupture
Risk Associated with Vacuum Deliveries
Vaginal Lacerations & Bladder Injury
Hematological Changes in the Postpartum Period
Mild changes to hemoglobin and hematocrit
Postpartum GI Nursing Interventions
Administer stool softeners
If patient has trouble passing stool assess for any signs of discoloration and edema.