N113 - High risk labor & delivery
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| Types of dysfunctional labor | show 🗑
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| show | Usually occurs during early stage of labor, less 4cm dilated. Contractions are frequent and resting time between & intensity is decreased. Pain > effectiveness of contractions = lactic acid cycle.
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| show | Stop or slow down contractions, with the hope of establishing more effective uterine activity.
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| show | Bedrest & sedation, IV fluids, may use oxytocin &/or ROM if pattern continues
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| show | Infrequent contractions, occurs after 4 cm dilation, mild to moderate intensity, fetal descent & cervical dilation slows, less intense & less productive.
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| show | Overstretched uterus, sedation, CPD - cephalopelvic disproportion
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| Hypertonic labor treatment | show 🗑
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| Pitocin half-life | show 🗑
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| Pitocin uses | show 🗑
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| Pitocin side effects | show 🗑
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| show | Lasting longer than 24 hrs, failure of cervix to dilate, need to prevent maternal & fetal complications
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| Prolonged labor causes | show 🗑
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| Prolonged labor complications | show 🗑
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| Prolonged labor treatment | show 🗑
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| Precipitous labor & delivery | show 🗑
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| Precipitous labor causes | show 🗑
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| Precipitous labor risks | show 🗑
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| show | May use MgSO4 (magnesium sulfate) to slow contractions. Can occur with oxytocin overdose
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| Preterm labor | show 🗑
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| Preterm labor contributing factors | show 🗑
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| show | Maternal - Psychological - concern for baby, Infection r/t PROM, risks r/t tocolytics & bedrest.
Fetal - Immaturity of organs, Intraventricular hemorrhage, high mortality
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| show | Early detection is key. Stop labor if - no cervical dilation, fetus is viable, no s/s of fetal distress, no medical or obstetrical disorders
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| Preterm labor - other managing factors | show 🗑
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| When preterm labor that shouldn't be stopped | show 🗑
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| When it might be okay to stop preterm labor | show 🗑
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| Ritodrine - Yutopar | show 🗑
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| Terbutaline sulfate - Brethine | show 🗑
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| show | Started subq then given PO or IV
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| Magnesium sulfate | show 🗑
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| show | Loading dose can cause flushing, warmth, headache, nausea, dizziness, nystagmus. Must watch for decreased deep tendon reflexes - clonus
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| Magnesium sulfate contraindications | show 🗑
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| Calcium gluconate | show 🗑
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| Magnesium sulfate fetal effects | show 🗑
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| show | Steroid given to increase lung maturity. Given only if labor can be delayed 24-48 hours.
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| Betamethasone celestone contraindications | show 🗑
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| Prolapsed umbilical cord | show 🗑
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| Prolapsed umbilical cord treatment | show 🗑
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| show | Extends beyond 42 weeks or 294 days
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| Post-term risks | show 🗑
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