Question

36. Describe amniocentesis. Why is it performed? How accurate is this test? What are the patient teaching and nursing interventions? 37. Describe an episiotomy. Explain what is done for episiotomy care. 38. List the causes,signs and symptoms of maternal hemorthage. 39. Define: uterine aony,How is this medically managed?

Answer 1

36. Amniocentesis is a process in which amniotic fluid sample is taken to check any abnormalities in the developing fetus. It is done in the second trimester by inserting a needle into the amniotic membrane and fluid is aspirated from there.

# It is performed to detect or screen abnormalities in the fetus as early as possible so that actions can be taken according to the findings to avoid complications . It helps to detect hereditary and chromosomal diseases .

# It is mostly done to detect genetic disease . Its 99% accurate in cases of Downs Syndrome , trisomy 18 and 98% accurate in neural tube defects.

# Patient teaching and nursing interventions in amniocentesis are :-

- Assess the vital signs of the patient before and after the procedure

- Take informed consent

- Drink plenty of fluids

- Empty bladder before the procedure to avoid puncture of nearby organs

- Monitor continuously fetal and maternal heart rate .

- Provide emotional and psychological support to the woman.

- Check for any bleeding and other complications .

37. Episiotomy is a surgical cut made at the vaginal opening during delivery to help a difficult delivery and to prevent rupture of tissues. It is also called perineotomy.

# Episiotomy care include :-

- Avoiding weight lifting for 6 weeks for early healing

- Avoid engaging in sex , using tampons etc

- Providing perineal care by using aseptic technique

- Use of analgesics and antibiotics to avoid pain and infections

- Assessing the perineal region for signs of infection like redness , temperature ,pus etc , changing the dressing every day after perineal care .

38. Causes of Maternal Hemorrhage are :-

- Uterine atony

- Prolonged laboratory

- Overdistention of uterus

- Anaesthesia

- Retained products of conception

- Pelvic trauma

- Obstructed labor

- Placenta previa

- Abruptio placenta

- Uterine inversion

- DIC

- Subinvolution

- Infection

- Coagulation disorder

# Signs and symptoms of Maternal Hemorrhage are :-

- tachycardia

- tachypnea

- hypotension

- increased thirst

- weakness

- pallor

- oliguira and anuria

- confusion

- coma

- death

39. Uterine atony is the failure of the uterus to contract after delivery of the baby . It is the most common cause of postpartum hemorrhage .

# It is medically managed by giving medicines :-

- oxytocin

- ergometrine

- hemabate

- misoprostol

All these cause rythmic contraction of uterus .

# Surgical management include :-

Balloon tamponade

Hemostatic brace suturing

Uterine massage

Arterial ligation

Hysterectomy

# Radiological management - Uterine artery embolization