COMPLICATIONS OF POWER

By: Melnie Rose D. Diaz , RN , MN

1L PNSS + 20 units of oxytocin to run for 30 gtts/min
• It will be due within 8 hours time

what is the correct OXYTOCIN DRIP

The graph that depicts normal uterine activity is likely graph A.

Which among here is the normal uterine activity?

Overdue –

If pregnancy is more than 40 weeks and above

Severe bleeding

HYPOVOLEMIC SHOCK is caused by?

Hypotonic Uterine Contractions

The number of contractions is usually low or infrequent (Not more than 2 or 3 occurrring in 10 minute period.)

The resting of the uterus remains less than 10 mm Hg, and the strength of contractions doesn’t rise above 25 mm hg.

The resting tof the uterus remains less than _____ mm Hg, and the strenght of contractions doesn’t rise above ________mm hg.

Active phase of labor

When does the hypotonic contraction occur mostly?

Differentiate Hyper and hypotonic Contracctions

Hypertonic uterine contractions

In contrast to hypotonic

contractions, these occur frequently and are most commonly seen in the latent phase of

labor. Marked by an increase in resting tone to more

than 15 mmHg

Answer: 1. Inadequate relaxation of the myometrium between contractions.

Hypertonic contractions may occur because more than one uterine pacemaker is

stimulating contractions or because the muscle fibers of the myometrium do not

repolarize or relax after a contraction, thereby “wiping it clean” to accept a new

pacemaker stimulus.

Which of the following is a potential cause of hypertonic uterine contractions?

1. Inadequate relaxation of the myometrium between contractions.

2. Excessive fluid intake by the mother.

3. Early administration of epidural anesthesia.

4. Maternal hypotension.

Answer: 2. Hypotonic contractions

Rationale:

• Hypotonic contractions are characterized by infrequent and weak contractions that are ineffective in dilating the cervix.

• Hypertonic contractions are frequent and strong, often leading to fetal distress.

• Precipitous labor involves rapid dilation and delivery, typically within 3 hours.

• Tachysystole refers to excessive uterine activity with more than five contractions in 10 minutes.

A client in active labor is experiencing contractions that are infrequent and of low intensity. The nurse recognizes that these contractions are characteristic of which of the following?

A. Hypertonic contractions

B. Hypotonic contractions

C. Precipitous labor

D. Tachysystole

Answer: 1. Fetal Anoxia

Rationale:

• The provided text states that hypertonic contractions can lead to fetal anoxia due to inadequate uterine artery filling during the short periods of relaxation between contractions.

• Fetal anoxia (lack of oxygen to the fetus) can cause fetal bradycardia (slow fetal heart rate).

• Distractors:

  • Early decelerations: These are typically caused by head compression during contractions, not necessarily related to anoxia.

  • Fetal tachycardia: While tachycardia can sometimes be a sign of fetal distress, it's not the most immediate concern in the context of hypertonic contractions and potential anoxia.

  • Variable decelerations: These are usually caused by umbilical cord compression, not directly related to the issue of inadequate uterine artery filling in hypertonic contractions.

A nurse is caring for a client experiencing hypertonic uterine contractions. Which of the following fetal complications is the nurse most concerned about?

1. Fetal anoxia

2. Early decelerations

3. Fetal tachycardia

4. Variable decelerations

Occur frequently in latent phase of labor

When does the hypertonic contraction usually occur

1. Evaluation of pelvic size

2. Maintenance of fluid and electrolyte balance

3. Therapeutic rest

✓ Analgesics (Morphine)

✓ Dark, quiet room

✓ Decrease noise and stimulation

4. Apply uterine and fetal monitor for 15 mins

5. Keep bladder empty – using straight-catheter

6. Encourage side lying position

7. Watch for danger signs

MANAGEMENT FOR HYPERTONIC

Answer: 3. Dimming the lights and minimizing noise.

Rationale: Therapeutic rest for hypertonic contractions aims to reduce uterine activity and promote relaxation. Dimming the lights and minimizing noise creates a calm and quiet environment, which can help the client relax and reduce uterine stimulation.

A client experiencing hypertonic uterine contractions is ordered therapeutic rest. Which of the following nursing interventions best supports this order?

1. Administering oral fluids as desired.

2. Encouraging frequent ambulation.

3. Dimming the lights and minimizing noise.

4. Applying continuous electronic fetal monitoring.

Answer: 2. Checking the client's blood pressure and respiratory rate.

Rationale: Morphine is an opioid analgesic that can cause respiratory depression. Therefore, assessing the client's vital signs, especially blood pressure and respiratory rate, is crucial before administration to identify any contraindications or potential risks.

A client with hypertonic contractions is prescribed morphine for pain management. What is the most important nursing assessment before administering this medication?

1. Assessing the client's pain level on a 0-10 scale.

2. Checking the client's blood pressure and respiratory rate.

3. Monitoring the fetal heart rate for at least 15 minutes.

4. Ensuring the client has voided within the last hour

Answer: 3. To ensure adequate bladder emptying to prevent uterine distention.

Rationale: A full bladder can impede the descent of the fetus and contribute to ineffective contractions. Inserting a urinary catheter ensures the bladder is empty, allowing for optimal uterine contractions and fetal descent.

A client with hypertonic contractions has a urinary catheter inserted. What is the primary rationale for this intervention?

1. To prevent urinary tract infection.

2. To facilitate frequent monitoring of urine output.

3. To ensure adequate bladder emptying to prevent uterine distention.

4. To provide comfort and reduce the need for frequent toileting.

Answer: 2. Hypotonic contractions

Rationale: Hypotonic contractions are characterized by infrequent and weak contractions that are ineffective in dilating the ce

A nurse is caring for a client in active labor who is experiencing contractions that are infrequent and of low intensity. The nurse recognizes that these contractions are characteristic of which of the following?

1. Hypertonic contractions

2. Hypotonic contractions

3. Precipitous labor

4. Tachysystole

Answer: 3. Postpartum hemorrhage

Rationale: The information states that hypotonic contractions can lead to uterine exhaustion, which can increase the risk of postpartum hemorrhage due to ineffective uterine contractions after birth

A client with hypotonic contractions is at increased risk for which of the following complications?

1. Premature rupture of membranes

2. Fetal tachycardia

3. Postpartum hemorrhage

4. Preeclampsia

.

Answer: 2. Pain is a subjective experience, and some clients may find hypotonic contractions painful.

Rationale: While the information states that hypotonic contractions are generally not painful due to their low intensity, it also acknowledges that pain perception is subjective.

Which of the following statements about the pain associated with hypotonic contractions is most accurate?

1. Hypotonic contractions are typically very painful.

2. Pain is a subjective experience, and some clients may find hypotonic contractions painful.

3. Hypotonic contractions are usually painless due to their low intensity.

4. Pain management is not typically necessary for clients with hypotonic contractions.

Answer: 2. Augmenting labor with oxytocin.

Rationale: Oxytocin is a medication commonly used to stimulate uterine contractions and augment labor in cases of hypotonic contractions.

Which of the following interventions is most likely to be implemented in the management of a client with hypotonic contractions?

1. Administering tocolytics to reduce uterine activity.

2. Augmenting labor with oxytocin.

3. Performing an amniotomy to stimulate contractions.

4. Applying continuous electronic fetal monitoring.

Infection

Cervical Dilation in mostly likely risk for?

CAUSES

• Overdistention of the uterus

• Malpresentation and malposition

• Pelvic bone contraction

• Unripe or rigid cervix

• Congenital abnormalities of the uterus

• Unknown causes

CAUSES of hypotonic contraction

Answer: 3. Polyhydramnios

Rationale: Polyhydramnios, which is an excess of amniotic fluid, can lead to overdistention of the uterus, which is listed as a potential cause of hypotonic contractions.

A nurse is caring for a client in labor with hypotonic contractions. Which of the following factors may contribute to the development of hypotonic contractions?

1. Premature rupture of membranes

2. Fetal tachycardia

3. Polyhydramnios

4. Preeclampsia

Answer: 3. Pelvic bone contraction

Rationale: Pelvic inflammatory disease can lead to pelvic adhesions and scarring, which can potentially contribute to pelvic bone contraction, a listed cause of hypotonic contractions

A nurse is assessing a client in labor who has a history of pelvic inflammatory disease. Which of the following potential causes of hypotonic contractions is most relevant to this client's history?

1. Overdistention of the uterus

2. Malpresentation and malposition

3. Pelvic bone contraction

4. Congenital abnormalities of the uterus

.

✓ Maternal and Fetal infections

✓ Postpartum hemorrhage

✓ Fetal distress and death

✓ Maternal exhaustion

COMPLICATIONS for hypotonic Contraction

Answer: 2. Fetal distres

A nurse is caring for a client in labor with hypotonic contractions. Which of the following complications is the nurse most concerned about?

1. Premature rupture of membranes

2. Fetal distress

3. Preeclampsia

4. Premature labor

Answer: 1. Precipitous Labor

A client arrives at labor and delivery experiencing sudden, intense contractions that began 30 minutes prior. Vaginal examination reveals 8 cm dilation and 100% effacement. Which term best describes this "blitzkrieg" labor pattern?

1. Precipitous Labor

2. Hypertonic Uterine Contractions

3. Hypotonic Uterine Contractions

4. Latent Phase of Labor

Answer: 1. Maternal exhaustion

Rationale: Prolonged labor associated with hypotonic contractions can lead to physical and emotional exhaustion in the mother.

A client with hypotonic contractions has a prolonged labor. Which of the following complications is a potential consequence of prolonged labor?

1. Maternal exhaustion

2. Premature rupture of membranes

3. Fetal tachycardia

4. Preeclampsia

Answer: 1. Postpartum infection

Rationale: The provided information lists maternal and fetal infections as potential complications of hypotonic contractions. Prolonged labor increases the risk of infection for both mother and baby

A nurse is caring for a client who delivered a baby after a prolonged labor complicated by hypotonic contractions. Which of the following postpartum complications is this client at increased risk for?

1. Postpartum infection

2. Preeclampsia

3. Gestational diabetes

4. Premature labor

.

Answer: 3. Precipitous labor

Rationale: Precipitous labor is defined by rapid cervical dilation and a short duration of labor.

A nurse is caring for a client in labor who progresses from 4 cm to 9 cm dilated within 1 hour. This rapid cervical dilation is characteristic of which of the following?

1. Hypotonic contractions

2. Hypertonic contractions

3. Precipitous labor

4. Prolonged labor

1. Reevaluate pelvic size to rule out fetopelvic disproportion.

2. Vaginal delivery

❑ Infusion of oxytocin –to augment labor

❑ Amniotomy may be done

3. If contracted pelvis is present, caesarian section is the method of delivery

4. Provide supportive nursing care

MANAGEMENT for hypotonic contraction

Answer: 2. Augmenting labor with oxytocin.

Rationale: The provided information lists oxytocin infusion as a method to augment labor in cases of hypotonic contractions.

A client in labor with hypotonic contractions is not progressing. Which of the following interventions is most likely to be implemented to stimulate labor?

• Administering tocolytics.

• Augmenting labor with oxytocin.

• Performing an amniotomy.

• Applying continuous electronic fetal monitoring.

Answer: 4. Cesarean section

Rationale: The information states that if a contracted pelvis is present, cesarean section is the recommended method of delivery.

A client with hypotonic contractions is found to have a contracted pelvis. Which of the following is the most likely method of delivery?

1. Vaginal birth after cesarean (VBAC)

2. Forceps-assisted vaginal delivery

3. Vacuum-assisted vaginal delivery

4. Cesarean section

PRECIPITATE LABOR

is cervical dilatation that occurs at a rate of 5 cm or more per hour

in a primipara or 10 cm or more per hour in a multipara.

Answer: 4. A multiparous client who is undergoing labor induction with oxytocin.

Rationale: The information states that precipitous labor can occur with the induction of labor by oxytocin.

Which of the following clients is at increased risk for precipitous labor?

1. A nulliparous client with a history of gestational diabetes.

2. A multiparous client who has undergone previous cesarean deliveries.

3. A nulliparous client with a history of preeclampsia.

4. A multiparous client who is undergoing labor induction with oxytocin.

Answer: 3. Subdural hemorrhage

Rationale:

• The provided text states that rapid labor can increase the risk of subdural hemorrhage in the fetus due to the rapid release of pressure on the head during delivery.

Which of the following fetal complications is a potential risk associated with rapid labor?

✓ Hemorrhage and lacerations

RISK FACTORS for PRECIPITATE LABOR

Multiparity

• Large pelvis

• Small baby in good position

• Induction of labor

• Absence of painful sensation and thus a lack of awareness of vigorous labor

PREDISPOSING FACTORS THAT CAN CAUSE PRECIPITATE LABOR

• Laceration of birth canal and uterine rupture

• Postpartum hemorrhage

• Amniotic fluid embolism

Maternal Complications in relation to Precipitate labor

• Hypoxia

• Intracranial hemorrhage

• Premature separation of placenta

• Injuries

Fetal Complications in relation to Precipitate labor

Answer: 1. Uterine rupture

Rationale: The provided information lists uterine rupture as a potential maternal complication of rapid labor

A nurse is caring for a client experiencing precipitous labor. Which of the following maternal complications is the nurse most concerned about?

1. Uterine rupture

2. Gestational diabetes

3. Preeclampsia

4. Premature labor

Answer: 1. Hypoxia

Rationale: The provided information lists hypoxia as a potential fetal complication of rapid labor, which can occur due to rapid delivery and potential for oxygen deprivation.

A client has just delivered a baby after experiencing precipitous labor. Which of the following fetal complications is the nurse most concerned about?

1. Hypoxia

2. Fetal bradycardia

3. Early decelerations

4. Premature rupture of membranes

• Patient complains of sudden, intense urge to push

• Sudden increase in bloody show

• Sudden bulging of the perineum

• Sudden crowning of the presenting part

SIGNS AND SYMPTOMS of precipitous labor

Answer: 3. Prepare for immediate delivery.

Rationale: The sudden crowning of the presenting part indicates that delivery is imminent. The nurse should prepare for immediate delivery by gathering necessary supplies and assisting the healthcare provider as needed.

A client in labor suddenly experiences crowning of the presenting part. Which of the following nursing interventions is most appropriate?

1. Apply gentle pressure to the fetal head.

2. Assist the client to push with each contraction.

3. Prepare for immediate delivery.

4. Administer oxygen via facemask

1. Anticipatory guidance for prevention

2. If accelerated labor pattern occurs during augmentation, stop the infusion.

3. Prepare for imminent delivery – wash hands, if the time permits. Never hold the baby back

MANAGEMENT for precipitate labor

Induction of labor

means labor is started artificially

Augmentation of labor

refers to assisting labor that has started spontaneously but is not effective

When labor contractions are ineffective, several interventions, such as induction and augmentation of labor with oxytocin or amniotomy (artificial rupture of the membranes), may be initiated to strengthen them

When labor contractions are ineffective, several interventions, such_______________________________________ with oxytocin or amniotomy (artificial rupture of the membranes), may be initiated to strengthen them

False: It should be 39 weeks of gestaion

T/F: Induction of labor is not used as an elective procedure until the fetus is at term (over 35 weeks of gestation).

CONTRACTION RINGS

refers to a tightening or induration of the uterine muscle fibers. It's a normal physiological phenomenon that occurs during labor.

• SIMPLE TYPE

• PATHOLOGIC RETRACTION (BANDL’SRING)

2 types of contraction ring

SIMPLE TYPE

can occur at any point in myometrium and anytime during labor

PATHOLOGIC RETRACTION (BANDL’SRING

most common, occurs at juncture of upper and lower uterine segments.

Answer: 2. A temporary tightening of the uterine muscle fibers that occurs during contractions.

Rationale: The information states that a physiologic contraction ring is a normal, temporary tightening of the uterine muscle that aids in labor progression.

A nurse is caring for a client in labor. Which of the following best describes a physiologic contraction ring?

1. A deep groove that forms across the uterus, typically at the junction between the upper and lower segments.

2. A temporary tightening of the uterine muscle fibers that occurs during contractions.

3. A permanent indentation across the abdomen that is visible during labor.

4. A condition that always requires immediate cesarean section.

Answer: 1. A horizontal indentation across the abdomen.

Rationale: The information states that a pathologic retraction ring can be identified by a horizontal indentation across the abdomen.

A client in labor is experiencing a pathologic retraction ring (Bandl's Ring). Which of the following clinical findings is most likely to be observed?

1. A horizontal indentation across the abdomen.

2. A rapid and steady cervical dilation.

3. A decrease in the frequency of contractions.

4. An increase in the strength of contractions.

• Appears late in 2nd stage of labor

• Horizontal indentation across abdomen

• Fetus is gripped by retraction ring and cannot advance beyond that point

• Warning sign of dysfunctional labor

• Uterine rupture or fetal death can occur • Also, will grip the placenta –leads to hemorrhage

MANIFESTATIONS of CONTRACTION RINGS

Answer: 2. Postpartum hemorrhage

A client with a pathologic retraction ring has delivered the baby. Which of the following postpartum complications is the nurse most concerned about?

1. Postpartum infection.

2. Postpartum hemorrhage.

3. Urinary tract infection.

4. Mastitis.

Excessive retraction of upper uterine segment • In early labor – due to uncoordinated contractions (obstetric manipulation or oxytocin

What is the etiology of the Contraction rings

1. Sonogram

2. IV morphine or inhalation of amyl nitrite

3. Cesarean birth

4. If it develops during the placental stage, it should be removed manually.

TREATMENT/MANAGEMENT for contraction rings

Relax Uterine Muscles: Both morphine and amyl nitrite have a relaxing effect on the uterine muscles

Rationale for using IV morphine or inhalation of amyl nitrite in the management of a pathologic retraction ring:

Answer: 2. Cesarean section

Rationale:

• The provided information states that cesarean section is a common treatment option for a pathologic retraction ring, as it is often necessary to deliver the baby when the ring is obstructing labor.

A client in labor is diagnosed with a pathologic retraction ring (Bandl's Ring). Which of the following is the most likely intervention?

1. Administration of IV morphine

2. Cesarean section

3. Induction of labor with oxytocin

4. Application of external fetal monitoring

If it develops during the placental stage, it should be removed manually

What happens if If it develops during the placental stage, should the patient wait until 39 weeks of pregnmamcy?

UTERINE RUPTURE

s a serious obstetric emergency that involves a tear in the wall of the uterus. This can occur during pregnancy or labor.

• Vertical scar from cesarean section

• prolonged labor

• faulty presentation

• multiple gestation

• unwise use of oxytocin

• traumatic maneuvers using forceps or traction

ETIOLOGY of uterine rupture

• Impending uterine rupture is often manifested by pathologic retraction ring

• With rupture a sudden severe pain, tearing feeling then pain stops

• Hemorrhage, shock

• Change in contour of abdomen • FHR absent

• changes in VS

MANIFESTATIONS for uterine rupture

Answer: 4. A horizontal indentation across the abdomen.

Rationale: The provided information states that a pathologic retraction ring, often manifested by a horizontal indentation across the abdomen, is a warning sign of impending uterine rupture.

A nurse is caring for a client in labor. Which of the following clinical findings is most suggestive of impending uterine rupture?

1. A sudden gush of clear fluid.

2. A gradual increase in the frequency and intensity of contractions.

3. A decrease in the frequency of contractions.

4. A horizontal indentation across the abdomen.

Answer: 3. Monitoring the fetal heart rate.

Rationale: The information states that uterine rupture can lead to fetal distress and absent fetal heart rate. Assessing the fetal heart rate is crucial to identify potential fetal compromise.

A client in labor suddenly experiences severe abdominal pain and reports a "tearing" sensation. Which of the following assessments is the nurse's priority?

1. Assessing the client's blood pressure and pulse.

2. Checking the client's temperature.

3. Monitoring the fetal heart rate.

4. Assessing for the presence of vaginal bleeding.

Answer: 2. Incomplete uterine rupture

Rationale: The information states that in incomplete uterine rupture, contractions may continue despite the presence of pain and other signs of rupture.

A client with a history of a previous cesarean section is experiencing persistent abdominal pain during labor, but contractions continue. Which type of uterine rupture is this most consistent with?

1. Complete uterine rupture

2. Incomplete uterine rupture

3. Dehiscence of the uterine scar

4. Physiologic retraction ring

Complete
Incomplete

TYPES OF UTERINE RUPTURE

INCOMPLETE

Localized tenderness and persistent pain over the abdomen

• Contractions may continue or stop but there is no progress

• Vaginal bleeding may or may not be present

• Signs of maternal shock and fetal distress are observed

Answer: 1. Complete uterine rupture

Rationale: The information states that complete uterine rupture is often characterized by sudden, excruciating pain at the peak of a contraction, followed by a cessation of contractions.

A nurse is caring for a client in labor who suddenly experiences excruciating abdominal pain at the peak of a contraction, followed by a cessation of contractions. Which type of uterine rupture is this most consistent with?

1. Complete uterine rupture

2. Incomplete uterine rupture

3. Dehiscence of the uterine scar

4. Physiologic retraction ring

COMPLETE

• Sudden excruciating pain at the peak of a contraction, then contractions stops altogether.

• Two swellings will be visible in the abdomen • Internal hemorrhage will soon follow, and vaginal bleeding may or may not occur

• Fetal hypoxia and death

Answer: 2. Assessing the client's blood pressure and pulse.

Rationale: Maternal shock is a significant complication of uterine rupture, characterized by hypotension and tachycardia. Assessing the client's vital signs is crucial to identify and manage shock.

A client with suspected uterine rupture is exhibiting signs of maternal shock. Which of the following assessments is the nurse's priority?

1. Monitoring the client's temperature.

2. Assessing the client's blood pressure and pulse.

3. Checking the client's urine output.

4. Monitoring the fetal heart rate.

1. Blood transfusion and administration of IVF

2. Administer oxygen

3. Provide emotional support

4. Stat Cesarian section

• may need a hysterectomy

• mother and/or fetus is in extreme jeopardy

MANAGEMENT for uterine rupture

Answer: 2. Preparing the client for a stat cesarean section.

Rationale: While all options are important, preparing for an immediate cesarean section is the priority intervention in a uterine rupture. This is a life-threatening emergency for both the mother and fetus, and rapid surgical intervention is crucial.

A client is diagnosed with a uterine rupture. Which of the following interventions is the PRIORITY for the nurse?

1. Administering pain medication.

2. Preparing the client for a stat cesarean section.

3. Providing emotional support to the client and family.

4. Initiating intravenous fluids and preparing for blood transfusion.

Answer: 4. Start an IV infusion with a large-bore needle.

Rationale: In cases of shock due to uterine rupture, rapid fluid resuscitation is critical. Establishing IV access with a large-bore needle allows for rapid administration of intravenous fluids and blood products to stabilize the client.

A client with a uterine rupture is exhibiting signs of shock. Which of the following actions should the nurse perform FIRST?

1. Administer oxygen.

2. Obtain informed consent for surgery.

3. Insert a Foley catheter.

4. Start an IV infusion with a large-bore needle.

iNVERTED UTERUS

Serious complication of the third stage of labor wherein the uterus is partly or completely turned inside out.

False.

In an inversion of the uterus, the fundus of the uterus (the top part) is no longer invertible. It has essentially turned inside out, becoming invaginated into the vagina.

T/F: In the inversion of the uterus, the fundus is still invertible

• Pulling of the umbilical cord or applying pressure on

• uncontracted uterus

• Placenta accrete

• Uterine relaxation due to effects of analgesia

• Sudden increase in intraabdominal pressure

CAUSES OF INVERTED UTERUS

• Fundus is no longer palpable

• Sudden gush of blood from the vagina

• Uterus appear in the vulva

SIGNS AND SYMPTOMS OF INVERTED UTERUS

Answer:

3. A sudden gush of blood from the vagina.

Rationale:

• The provided information states that a sudden gush of blood from the vagina is a key sign and symptom of uterine inversion

A nurse is caring for a postpartum client. Which of the following clinical findings is most suggestive of uterine inversion?

1. A firm, contracted uterus fundal height at the umbilicus.

2. Moderate lochia rubra.

3. A sudden gush of blood from the vagina.

4. Mild uterine cramping.

1. PREVENTION

✓ Never apply pressure on an uncontracted uterus

✓ Never pull the cord to hasten placental delivery

2. If the placenta has already separated: the uterus is replaced in the uterine cavity then oxytocin is administered.

3. If the placenta is still attached: woman is placed under anesthesia to cause muscular relaxation and facilitate reinsertion of the uterus into the pelvic cavity. 4. Blood transfusion and administration of IVF

5. Monitor vital signs

MANAGEMENT OF INVERTED UTERUS

AMNIOTIC FLUID EMBOLISM

occurs when amniotic fluid is forced into an open maternal uterine blood sinus after a membrane rupture or partial premature separation of the placenta

labor or in the post-partal period.

AMNIOTIC FLUID EMBOLISM, This condition may occur during___________

✓ Induction of labor

✓ Multiple Pregnancy

✓ Polyhydramnios

AMNIOTIC FLUID EMBOLISM may be associated with

False.

Amniotic fluid embolism (AFE) is not highly preventable. It's a rare and unpredictable complication of pregnancy and childbirth. While some risk factors may be identified, it's generally considered an unpredictable event. There aren't reliable ways to prevent it from occurring.

T/F: AMNIOTIC FLUID EMBOLISM is highly preventable

• Usually, patient is in active phase of labor

• Suddenly and grasps her chest

• Inability to breathe

• Skin is pale and may turn bluish gray

• May become unconscious

• Fetus may be in danger

CLINICAL MANIFESTATIONS

of AMNIOTIC FLUID EMBOLISM

Answer: 3. Amniotic fluid embolism

Rationale: The provided information states that sudden respiratory distress and chest pain are key clinical manifestations of amniotic fluid embolism.

A nurse is caring for a client in active labor who suddenly complains of difficulty breathing and grasps her chest. Which of the following complications is the nurse most concerned about?

1. Preeclampsia

2. Pulmonary embolism

3. Amniotic fluid embolism

4. Uterine rupture

1. Oxygen administration by face mask or cannula

2. Prepare for CPR

3. Watch for signs and symptoms of DIC

4. Anticipate intubation and fibrinogen therapy

MANAGEMENT

for Amniotic fluid embolism

Answer: 1. Administering oxygen via facemask.

Rationale: The provided information states that oxygen administration is a priority in the management of AFE to support respiratory function.

A client experiencing suspected amniotic fluid embolism is exhibiting signs of respiratory distress. Which of the following interventions is the priority?

1. Administering oxygen via facemask.

2. Preparing for cesarean section.

3. Monitoring fetal heart rate.

4. Administering pain medication.

Answer: 3. Disseminated intravascular coagulation (DIC)

Rationale: The provided information states that monitoring for signs and symptoms of DIC is crucial in the management of AFE.

A client with suspected amniotic fluid embolism is at increased risk for which of the following complications?

1. Postpartum hemorrhage

2. Preeclampsia

3. Disseminated intravascular coagulation (DIC)

4. Urinary tract infection

LABOR INDUCTION

deliberate intention of labor before it occurs spontaneously.

AUGMENTATION OF LABOR

refers to the stimulation of effective uterine contractions when contractions are inadequate

• No cephalopelvic disproportion exist

• Fetus is mature, or pregnancy is at term

• Cervix is ripe soft & dilatable, with some degree of cervical dilatation and effacement

• Fetus is longitudinal lie, presenting part is engaged

PREREQUISITES FOR LABOR INDUCTION

✓ Maternal complications

✓ Premature Rupture of Membranes

✓ Placental Insufficiency

✓ Intrauterine growth retardation

✓ Intrauterine fetal death

What is INDUCTION & AUGMENTATION OF LABOR indicated for

• Oxytocin (Pitocin): Synthetic hormone to stimulate contractions.

• Prostaglandins (Cervidil, Cytotec, Prepidil): Soften and ripen the cervix.

• Amniotomy (Artificial Rupture of Membranes - AROM): Breaking the amniotic sac.

• Mechanical Methods (Foley catheter): Dilate the cervix.

METHODS OF LABOR INDUCTIONS

False.

Nipple stimulation is a non-pharmacological method of labor induction. It works by stimulating the release of oxytocin, a hormone that causes uterine contractions. Since it doesn't involve any medications, it's not considered pharmacological

T/F: Is stipple stimulation considered a pharmacological method of labor induction?

AMNIOTOMY

It is the artificial rupturing of membranes using amniotomy forceps such as amniohook or allis forceps.

AMNIOHOOK
Allis

What equipments are being used fo amniotomy