Question

please help

please answer these questions

1. If a mother could deliver vaginally but needed help from forceps or a vacuum extractor, (Also called operative or instrumented delivery) what might some complications be for mom and or baby?

2. What is important for nurses to know about medications or anesthesia during labor/for C-Section? (What are the potential problems/complications?) (E.g. potential for effect on fetus with IV narcotics, need to pre-load woman with IV fluid BEFORE epidural procedure, and be ready to administer boluses AFTER epidural medications begin to work if HYPOTENSION occurs.)

3. how to recognize signs that a woman is going in to labor.

How would you recognize each PHASE of Stage 1 based on what the woman is experiencing? How might she be acting? What support does she need?

What are NON-Pharmacologic options for pain relief?

What are the stages of labor/birth, etc

4. Are there any nursing interventions that can be done to change the P? for example we can give oxytocin to improve contraction strength and frequency, but we cannot change the facts of a baby’s head being too big to fit through the mom’s pelvis.

5. Placenta issues-previa and abruption How would you recognize signs and symptoms of abruption? Cord Prolapse?

Answer 1

1. Complications of instrumental delivery

For mother

• perineal tear
• cervical laceration
• vaginal laceration
• episiotomy extension
• traumatic hemorrhage
• uterine rupture
• urinary retension

For baby

• bleeding inside baby's skull or skull fracture
• damage to baby's facial nerve
• swelling on baby's head
• trauma to the baby's eyes
• brain injury to the baby,such as a cerebral palsy

2. Role of nurse

monitor the women's

• vital signs
• level of mobility
• ,level of consciousness,
• perception of pain
• level of pain relief
• monitor fetal status
• stop the continuous infusion if there is a safety concern or the women has given birth

Initiate emergency therapeutic measures if complications arise according to institutional policy,protocol

Increase or decrease the rate of continuous infusion

Preparation and programming the medication and infusion devices

toxicity with anesthetic medications can occur as a complication

repiratory depression in the new born baby also occur

common minor complications includes

• mild hypotension
• bradycardia
• nausea and vomiting
• transient neurological symptoms
• urinary retension
• post dural puncture headache

3. signs of labor

on several occasions the labor start slowly and it may not be something sudden or dramatic.it may take few hours to few days to develop the labor

• Backache before labor:
• There will be a relief from the heart burn
• breaking of the water
• leaking of the nipples
• swelling in private parts
• Increased frequency to toilets and diarrhoea
• change in waking gait
• sensation of tightening
• sudden energetic feeling

As a nurse she should responsible for coordinating and documenting the care of the laboring women and her fetus.,which include providing direct physical care and support of the women and support of partner and family members during labor.

non pharmacological pain relief methods

• massage and heat:massage and hot packs can ease your pain in labor
• water immersion
• relaxation therapy
• aromatherapy
• acupuncture
• sterile water injections
• usage of TENS machine

STAGES OF LABOR

labor progresses through three stages

1. Dilation
2. expulsion
3. placental expulsion

DILATION:

can last anywhere 2-16 hours or more.initially each contraction is 30-45 sec.their function is to dilate the cervix until it is wide enough to let the baby through,usually about 10 cm

EXPULSION:

in this ,the involuntary contractions continue to be long in duration and closely spaced,but now the women has a strong urge to bear down with her abdominal muscle.slowly baby's scalp came into view.it is known as crowning.expulsion of baby take place in 2nd stage of labor.duration of this stage is 2 hours

PLACENTAL EXPULSION::

During the placental stage,the afterbirth (the placenta and cord)is expelled from the uterus.labor is now completed.duration is 15 -20 minutes.15 hrs is the entire time for the labor process.

5. placenta previa:

when the placenta covers the opening in the mother's cervix is called placenta previa .

The main symptom is bright red vaginal bleeding without pain during the stage 2 of pregnancy.the condition can also cause severe bleeding before or during delivery

placental abruption:

A serious pregnancy complication in which the placenta detaches from the womb.the condition can deprive the baby of oxygen and nutrients.

symptoms include bleeding,stomach pain,and back pain,in the last 12 weeks of pregnancy.

cord prolapse:

umbilical cord prolapse is a complication that occur prior to or during delivery of the baby.in prolapse the cord drops through the open cervix and  ahead of the baby.the cord can then became trapped against the baby's body during delivery