augmentation, induction

oxytocin augmentation

RN titrate to affect
low - inc 1mu/min q30min
high - inc 2mu/min q15min
ivpb mainline lr
monitor iupc
measure mvus

amniotomy

MD use hook, rupturing device

pitocin nursing implications

hyperstim uterus - reversal agent terbutaline
impair uterine blood flow - fetal hypoxia, up compromised, turn off infusion
bp inc 30%
inc freq assess
uterine rup, water tox, abrupt

chemical induction

prostags
pge1 - miso
pge2 - cervidil, dinoprostone

mechanical induction

cervical balloon
hydrostatic dilators - laminaria
striping membranes

op vag delivery - forceps

rotate fetal head to oa position
used if fetal head low - > +2 station

forcep nurse role

monitor uc, fhr
plan for resuscitation
nb - bruising, cerebral edema, hematoma
mom - perineal swelling, inc pain

op vag delivery - vacuum

cup attach, negative pressure assist head birth
vertex present, rup membrane, absence of cpd
faster delivery, last chance before csec

vacuum management

+2 station, on occiput
do not use >10min, 3 pop offs, preterm fetus - cause ivh