Scribd Logo
Upload

Welcome to Scribd!

  • 85 views

    Prob With The Power

    Uploaded by

    Pauline Navarro
    This document discusses problems that can occur during labor and delivery, including dystocia (difficult labor). It describes two types of uterine dysfunction - hypertonic and hypotonic - that can cause ineffective contractions and lack of cervical dilation. It also discusses abnormal progress in the first and second stages of labor, such as a prolonged latent phase, active phase, or descent phase. Nursing and medical management strategies are provided for each problem, which may include monitoring, analgesics, oxytocin administration, amniotomy, or cesarean section if there is lack of progress or fetal distress.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd

    Prob With The Power

    Uploaded by

    Pauline Navarro
    85 views4 pages
    This document discusses problems that can occur during labor and delivery, including dystocia (difficult labor). It describes two types of uterine dysfunction - hypertonic and hypotonic - that can cause ineffective contractions and lack of cervical dilation. It also discusses abnormal progress in the first and second stages of labor, such as a prolonged latent phase, active phase, or descent phase. Nursing and medical management strategies are provided for each problem, which may include monitoring, analgesics, oxytocin administration, amniotomy, or cesarean section if there is lack of progress or fetal distress.

    Original Title

    PROB WITH THE POWER

    Copyright

    © © All Rights Reserved

    Available Formats

    DOCX, PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    This document discusses problems that can occur during labor and delivery, including dystocia (difficult labor). It describes two types of uterine dysfunction - hypertonic and hypotonic - that can cause ineffective contractions and lack of cervical dilation. It also discusses abnormal progress in the first and second stages of labor, such as a prolonged latent phase, active phase, or descent phase. Nursing and medical management strategies are provided for each problem, which may include monitoring, analgesics, oxytocin administration, amniotomy, or cesarean section if there is lack of progress or fetal distress.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    85 views4 pages

    Prob With The Power

    Uploaded by

    Pauline Navarro
    This document discusses problems that can occur during labor and delivery, including dystocia (difficult labor). It describes two types of uterine dysfunction - hypertonic and hypotonic - that can cause ineffective contractions and lack of cervical dilation. It also discusses abnormal progress in the first and second stages of labor, such as a prolonged latent phase, active phase, or descent phase. Nursing and medical management strategies are provided for each problem, which may include monitoring, analgesics, oxytocin administration, amniotomy, or cesarean section if there is lack of progress or fetal distress.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    You are on page 1of 4

    PROBLEMS WITH THE POWER

    a. Dystocia (Difficult Labor)


    1. Hypertonic Uterine Dysfunction
    - frequent contractions at midsegment of the uterus with decreased intensity and increased
    uterine tone occurring during the latent phase of labor.
     Ineffective in causing cervical dilatation or effacement to progress
     Uterus does not relax complete between contractions
     Occurs before 4cm dilation
    Maternal risk
     Loss of control related to the intensity of pain and lack of progress
     Exhaustion
    Nursing management
     Decrease noise and stimulation
     Monitor FHT and labor progress
    Medical management
     Monitor uterine contractions
     Initiate therapeutic rest measures (bed rest)
     Administer analgesic (morphine sulfate)
     CS birth indications – the presence of late deceleration, abnormally long first stage of
    labor and lack of progress with pushing
    Hypotonic Uterine dysfunction
     Low or infrequent contractions
     Contractions that is not increasing beyond 2 to 3 in a 10minute period
     Resting tone of the uterus remains less than 10mmHg
     Strength contractions does not rise above 25mmHg
     Most occur on the active phase of labor
    Cause
     Administration of analgesia
     Bowel or bladder distention
     Overstretched uterus due to multiple gestation
     Macrosmia
    Maternal risk
     Ineffective cervical dilatation
     Prolonged labor
     Ineffective uterine contraction during the post-partal period
     Possible post-partal hemorrhage
     Risk for infection
    Nursing management
     Palpate uterine fundus
     Monitor BP
     Monitor lochia every 15 minutes
    Medical management
     Administration of oxytocin – strengthen contractions and increase their effectiveness
     Amniotomy (artificial rupture of membranes) - to improve labor and further speed labor

    ABNORMAL PROGRESS IN LABOR


    DYSFUNCTION ATHE FIRST STAGE OF LABOR
    Prolonged Latent Phase
     Ineffective contractions during the first stage of labor
     >20 hours in a nulliparous patient
     > 14 hours in a multiparous patient
    Causes
     Cervix is not “ripe”
     Excessive use of analgesic early in labor
    Signs and symptoms
     Hypertonic uterus
     Inadequate relaxation
     Mild & ineffective contractions – less than 15mmHg
    Nursing management
     Changing linen and woman’s gown
     Darkening room
    Medical Management
     Help uterus to relax
     Adequate fluid for rehydration
     Pain relief (morphine sulfate)
     Oxytocin infusion to assist labor may be necessary
     Cesarean birth
    Prolonged Active Phase
     Dilatation <1.2 cm in nulliparous
     Dilatation <1.5 cm in multiparous
     Active phase lasts > 12 hours in primigravida
     Active phase lasts >6 hours in multigravida
    Cause
     Fetal malposition and malpresentation
    Signs and symptoms
     Hypotonic uterus
     Ineffective cervical dilation
    Management
     Ultrasound to show that CPD is not present
     Oxytocin to enhance labor
     If the cause is fetal malposition or CPD, CS birth is done
    Prolonged Deceleration Phase
     Deceleration phase extends beyond 3 hours in a nullipara or 1 hour in multipara
    Cause
     Abnormal fetal head position
    Signs and symptoms
     >3 hours in nullipara, >1 hour in multipara
    Management
     Cesarean delivery
    DYSFUNCTION WITH THE SECOND STAGE OF LABOR (EXPULSION STAGE)
    Prolonged Descent
     Descent is <1cm/hr in a nullipara, <2cm/hr in a multipara
     Infrequent contractions and of poor quality and dilatation stop
    Management
     Rest
     IV fluid therapy
     Amniotomy
     If membranes have not ruptured, rupturing them may be applicable
     IV oxytocin
     Semi- fowler's position, squatting, kneeling, or more effective pushing may speed descent
    Arrest of Descent
     no descent has occurred for 1 hour in a multipara or 2 hours in a nullipara
     Movement beyond 0 a station has not occurred
    Cause
     CPD
    Management
     Oxytocin to assist labor if vaginal birth

    https://nurselabs.com/problems-fetal-position-presentation-size-passage
    https://www.glowm.com/section_view/heading/Abnormal%20Labor:%20Diagnosis%20and
    %20Management/item/132

    You might also like