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A gravida 2, para 0 at 42 weeks’ gestation is admitted to the L&D suite for oxytocin induction of labor for post dates. The client’s cervix is favorable at 2 cm dilated, 70% effaced, and –1 station. Fetal presentation if vertex. Before oxytocin induction begins, the provider performs an amniotomy.
- What are the nursing responsibilities before, during, and after this procedure?
- What are the major side effects of oxytocin that the nurse must be alert to when managing induction of labor?
- What primary interventions should the nurse take when noting a hyperstimulation pattern on the external fetal monitor?
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- A 29 y/o, G3P2, 35 weeks gestation presents for prenatal care. She complains of on and off scanty vaginal bleeding not associated with other signs and symptom. Your impression is placenta previa. The simplest, most precise and safest method to confirm your diagnosis is which of the following? Sonography Magnetic resonance imaging Computed tomography Double set-up examinationMaternal and Newborn Health Unit Liverpool School of Tropical Mediine LSTM/RCOG Lie Saving Skilh -Eential (Emergency) Obstetic Care and Niewborn Care LSTM Symbols Usual frequency of examina tion Cervix Vaginal examination 4 hourly Head X - X hourly Fetal Heart Rate Breech Fetal heart rate Contractions: Palpate abdomen (uterine fundus)over 10 min. «20 seconds Mild Amniotic fluid Maderate 20-40 seconds Membranes intact Strong >40 seconds Membranes ruptures, clear fluid Descent: Abdominalpalpation Meconium stained fluid M 45 35 2 Biood stained fluid Abdomer Moulding Sutures apposed Helve covty Sutures overlapped but reducible 2+ Conpety Sp Sincipa Encixt Groput re M Ng y Sutures overlapped but not reducible Ocuut Ou Ox O jae ra 1. WHO Managing compications in pregnancy and chidbirm 1 Matemal and Newban Health Unit iverpool School of Tropical Medicine LSTM/RCOG Life Saving Skils-Easential (Emergency) Obstetric Care and Newborn Cam LSTM Name: Mrs DG Partograph Case 3 Hospital No.: 462432 XY…On performing Leopold's maneuver to Mrs. Vanessa Narciso, a multiparous client in early laborNurse Marina finds no fetal parts in the fundus or above the symphysis The fetal head is palpated in the right mid quadrant Nurse Marina notifies the obstetrician the following is safe to assume? Footling breech Occiput presentation Compound presentation Transverse lie
- Tracy is a 25-year-old woman, Roman Catholic, from a semi-remote First Nation Community, L.A., Laguna. She is 37weeks pregnant, 65 kgs and attending a prenatal visit with her community nursetoday. This is her third pregnancy and she has attended all previous visits with her mother and/or Frank, the father of her baby. She stated that she experience minimal vaginal discharge, with mild contraction.Tracy is very quiet and makes limited eye contact during visit. Tracy’s pregnancy has been fairly uneventful. Laboratory values (Complete blood count (CBC), hepatitis B Screening (HBSag) ,Urinalysis(UA), ABO typing) and vital signs have been within normal limits. A 20-week ultrasound found no abnormalities of fetal anatomy. During her visit the nurse told her the labor signs and symptoms and when to go for hospitalization.A 32 year old G1P0 seeks consult for initial obstetric visit. Diagnostic procedures are requested and medication are given by the Obstetrician-Gynecologist. The nurse is conducting health teaching. At 20 weeks age of gestation, all of the following developments in the fetus has already occured? (SELECT ALL THAT APPLY) Downy lanugo hair surrounds the skin -(baka di kasama to) Gender can be determined by UTZ Physiologic herniation of the gut has occurred Urine production has beganAn internal examination of a 20 year old client revealed the following: cephalic presentation, cervix 3 cms dilated, 75% effaced, station is -1 frequency is 2-3 minutes, duration 45 seconds, moderate intensity. When asked to perform the partograph, which of the following indicates that the nurse needs further teaching?a.Latent phase of laborb. Active phase of laborc. There should be 2 contractions or more in 10 minutesd. Duration of contractions is 20 seconds or more
- Mrs. Zexy Lucero, 25 years old, G1PO, 39 4/7 weeks age of gestation is in labor. Internal examination revealed: cervix 5-6 cms dilated, 50% effaced, cephalic, Station 0, (+) BOW. External fetal monitoring revealed a variable decelerations. Nurse Zasha is preparing for cesarean birth. Which of the following activities should not be implemented without clarification by Nurse Zasha? (Select all that apply) Slow the intravenous flow rate. Continue the oxytocin drip if infusing. Place the client in a high Fowler's position Administer oxygen, 8 to 10 L/ minute, via face maskA client with an internal fetal monitor catheter in place has just received IV butorphanol (Stadol) for pain relief. Which of the following monitor tracing changes should the nurse anticipate? 1. Early decelerations. 2. Late decelerations. 3. Diminished short- and long-term variability. 4. Accelerations after contractions.Marielle, a 27 year-old Gravida 2 Para weeks AOG was admitted in labor. Fundic height was measured at 30 cms with good fetal heart tone. Cervix is 4 cm dilated, not effaced, station - 1. About 1 hour after admission, IE findings remained the same. What would be the most appropriate thing to do?a. Observe and evaluateb. Deliver the baby by CSc. Give oxytocin drip to augment labord. Ask patient to walk around to hasten labor amniotomy
- Mrs. Vanessa Narciso 25-year-old G1PO who seek consult for the first time at 20 weeks age of gestation is being taken care of by an obstetric nurse. A priority goal for Mrs. Vanessa is that able to: Attend prenatal care appointments on a regular basis Explain the process of fetal development Record the number of the fetal movements 4 times a day Maintain a steady weight gainTracy is a 25-year-old woman, Roman Catholic, from a semi-remote First Nation Community, L.A., Laguna. She is 37weeks pregnant, 65 kgs and attending a prenatal visit with her community nurse today. This is her third pregnancy and she has attended all previous visits with her mother and/or Frank, the father of her baby. She stated that she experience minimal vaginal discharge, with mild contraction.Tracy is very quiet and makes limited eye contact during visit. Tracy’s pregnancy has been fairly uneventful. Laboratory values (Complete blood count (CBC), hepatitis B Screening (HBSag) ,Urinalysis(UA), ABO typing) and vital signs have been within normal limits. A 20-week ultrasound found no abnormalities of fetal anatomy. During her visit the nurse told her the labor signs and symptoms and when to go for hospitalization. I. Using the information above: Make a Nursing Care PlanHeather Shane, a 26 y.o. G1P0, presents to the labor unit for elective induction of labor at 39 weeks gestation. She has with her the following admission orders: Admit to labor unit for elective IOL LR at 125 mL/hr after initial bolus of 500 mL SVE q 2 hrs O2 via facemask at nurse discretion Cytotec 25.0 mcg buccal q 4 hrs Pitocin 2 mg/min after 4cm dilated max 30 mu/min Regular diet until active labor PCN 5 million units initial dose and 2.5 million units q 4 hrs until delivery IV Cont. EFM IUPC/FSE as needed per RN Call with VS out of range Methergine 0.2 mg IM PRN bleeding Carboprost 250 mcg IV PRN bleeding Pitocin 20 units IV bolus at delivery of placenta Upon placing Mrs. Shane on the monitor you note FHR in the 130’s with good variability and occasional variable decels. She reports a history that includes gestational hypertension that she takes medication for. She denies being able to recall name of medication, but knows that it is 200 mg by mouth once in the morning and…