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Fetal Malposition
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What are nursing interventions for fetal malposition?
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| Question | Answer |
|---|---|
| Fetal Malposition | Abnormal positioning of the fetus in the uterus. |
| What are nursing interventions for fetal malposition? | Back rub, repositioning, warm/cold compress, voiding every 2 hours. |
| Fetal Malpresentation | The fetal body part that first contacts the cervix is not in the normal cephalic position. |
| What are nursing interventions for fetal malpresentation? | Ultrasound, forceps (if mentum anterior), C-section if labor arrests, fetal heart monitoring. |
| What causes fetal distress? | Placental insufficiency, uterine overstimulation, cord compression, multiple pregnancy. |
| What are nursing interventions for fetal distress? | Induction, C-section, left lateral position, oxygen administration. |
| Umbilical Cord Prolapse | A loop of the umbilical cord slips ahead of the fetal presenting part. |
| What are the types of umbilical cord prolapse? | Overt (visible) and Occult (hidden but detectable via fetal bradycardia). |
| What are nursing interventions for umbilical cord prolapse? | Manually elevate fetal head, knee-chest or Trendelenburg position, oxygen, tocolytics, keep exposed cord moist. |
| Cephalopelvic Disproportion (CPD) | Fetal head is too large to pass through the mother's pelvis. |
| What are nursing interventions for CPD? | C-section if confirmed, trial of labor if baby is average-sized. |
| Shoulder Dystocia | The fetal head is delivered, but the shoulders are too broad to pass through the pelvic outlet. |
| What are nursing interventions for shoulder dystocia? | McRobert’s maneuver, suprapubic pressure. |
| Premature Labor | Labor before 37 weeks of gestation. |
| What are nursing interventions for premature labor? | Hydration, bed rest, infection screening, tocolytics if criteria met. |
| Precipitate Labor | It is a labor that completes in fewer than 3 hours. |
| What are nursing interventions for precipitate labor? | Predict labor progress, tocolytics, timely transport planning. |
| Uterine Rupture | The uterus tears due to excessive strain. |
| What are signs of uterine rupture? | Tearing sensation, Bandl’s ring, signs of shock. |
| What are nursing interventions for uterine rupture? | IV fluids, prepare for laparotomy, possible hysterectomy. |
| Postpartum Hemorrhage | Blood loss > 500 mL within 24 hours postpartum. |
| What are causes of postpartum hemorrhage? | Uterine atony, lacerations, retained placenta, DIC. |
| What are nursing interventions for postpartum hemorrhage? | Fundal massage, oxytocin, transfusion if needed. |
| Endometritis | Infection of the uterus, often after cesarean birth. |
| What are signs of endometritis? | Fever, foul-smelling lochia. |
| What are nursing interventions for endometritis? | Antibiotics, increased fluids, early detection. |
| Peritonitis | Infection of the peritoneal cavity. |
| What are signs of peritonitis? | Rigid abdomen, high fever, vomiting. |
| What are nursing interventions for peritonitis? | IV fluids, TPN, analgesics, antibiotics. |
| Uterine Atony | The uterus fails to contract properly after delivery, leading to hemorrhage. |
| What are risk factors for uterine rupture? | Prolonged labor, multiparity, oxytocin use, traumatic maneuvers using forceps or traction |
| What are nursing interventions for uterine atony? | Fundal massage, oxytocin IV, methylergonovine, blood transfusion if needed. |
| What are lacerations in labor? | Tears in the cervix, vagina, or perineum that cause excessive bleeding. |
| What are nursing interventions for cervical lacerations? | Assist in repair, provide pain management, reassure the mother. |
| What are vaginal lacerations and how are they managed? | Tears in the vaginal wall; may need vaginal packing and Foley catheter. |
| Perineal Laceration | A tear in the perineum, classified into four degrees based on severity. |
| What are nursing interventions for perineal lacerations? | Episiotomy repair, stool softeners for 3rd and 4th-degree tears, no rectal procedures. |
| What is a retained placental fragment? | Part of the placenta remains in the uterus, preventing full contraction and causing hemorrhage. |
| What are nursing interventions for retained placenta? | Dilation and curettage (D&C), methotrexate if needed, monitor lochia. |
| Uterine Inversion | The uterus turns inside out, often due to excessive traction on the cord or fundal pressure. |
| What are signs of uterine inversion? | Fundus is not palpable, large blood loss, hypotension, dizziness. |
| What are nursing interventions for uterine inversion? | Do not replace the uterus manually, IV fluids, oxygen, prepare for surgery. |
| Disseminated Intravascular Coagulation (DIC) | A life-threatening clotting disorder triggered by conditions like placental abruption or infection. |
| What are nursing interventions for DIC? | Administer heparin as ordered, blood transfusions, monitor coagulation studies. |
| What is subinvolution of the uterus? | The uterus fails to return to its normal size postpartum. |
| What are nursing interventions for subinvolution? | Administer methylergonovine, antibiotics if infection is present, educate on normal involution. |
| What is a perineal hematoma? | A collection of blood in the perineal tissue, causing pain and swelling. |
| What are nursing interventions for perineal hematoma? | Ice packs, analgesics, report size to the doctor, possible surgical drainage. |
| Puerperal Infection | An infection occurring after childbirth, often due to bacteria entering the uterus. |
| What are nursing interventions for puerperal infection? | Administer antibiotics, monitor temperature, encourage fluids and sensitivity testing |
| Dilation and Curettage | To remove the fragments after giving birth whether it's blood/lochia, or placental fragments or anything that is in there. |
| Medication to reduce/inhibit contraction | Isoxsuprine |
| Medication to increase contraction | Oxytocin |
| Medication for Hyperemesis Gravidarum | Reglan |
| Fetal Distress | When a baby displays signs that it may not be coping when in the uterus |
| Common symptoms of Prolapse of the Umbilical Cord | persistent, dull, low backache o vaginal spotting o feeling of abdominal pressure or tightening o increased vaginal discharge o uterine contractions o intestinal cramping |
| Classification of Uterine Rupture | complete rupture and incomplete rupture |
Created by:
Jon Anderson
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