Dysfunctional Labour
Description
▪ Dysfunctional labour is difficult, painful, prolonged labour due to
mechanical factors.
Aetiology
1. Fetal factors (passenger) include unusually large foetus, fetal
anomaly, malpresentation, and malposition
, 2. Uterine factors (powers) include hypotonic labour, hypertonic labour,
precipitous labour, and prolonged labour.
3. Pelvic factors (passage) include inlet contracture, mi pelvis
contracture, and outlet contracture.
4. “Psyche” factors include maternal anxiety and fear and lack of
preparation.
Pathophysiology
▪ Uterine contractions are ineffective secondary to muscle fatigue or
overstretching.
Assessment Findings
▪ Clinical manifestations include irregular uterine contractions and
ineffective uterine contractions in terms of contractile strength and
duration.
Nursing Management
1. Optimize uterine activity. Monitor uterine contractions for
dysfunctional patterns; use palpation and an electronic monitor.
2. Prevent unnecessary fatigue. Check the client’s level of fatigue and
ability to cope with pain.
3. Prevent complications of labour for the client and infant.
▪ Assess urinary bladder; catheterize as needed.
▪ Assess maternal vital signs, including temperature, pulse,
respiratory rates, and blood pressure.
▪ Check maternal urine for acetone (an indication of dehydration
and exhaustion).
▪ Assess condition of foetus by monitoring FHR, fetal activity, and
colour of amniotic fluid.
4. Provide physical and emotional support.
▪ Promote relaxation through bathing and keeping the client and
bed clean, back rubs, frequent position changes (sideling),
walking (if indicated), and by keeping the environment quiet.
▪ Coach the client in breathing and relaxation techniques.
5. Provide client and family education.
Risk For Fluid Volume Deficit
Risk for fluid volume deficit: At risk for experiencing vascular, cellular, or
intracellular dehydration.
Risk factors
Description
▪ Dysfunctional labour is difficult, painful, prolonged labour due to
mechanical factors.
Aetiology
1. Fetal factors (passenger) include unusually large foetus, fetal
anomaly, malpresentation, and malposition
, 2. Uterine factors (powers) include hypotonic labour, hypertonic labour,
precipitous labour, and prolonged labour.
3. Pelvic factors (passage) include inlet contracture, mi pelvis
contracture, and outlet contracture.
4. “Psyche” factors include maternal anxiety and fear and lack of
preparation.
Pathophysiology
▪ Uterine contractions are ineffective secondary to muscle fatigue or
overstretching.
Assessment Findings
▪ Clinical manifestations include irregular uterine contractions and
ineffective uterine contractions in terms of contractile strength and
duration.
Nursing Management
1. Optimize uterine activity. Monitor uterine contractions for
dysfunctional patterns; use palpation and an electronic monitor.
2. Prevent unnecessary fatigue. Check the client’s level of fatigue and
ability to cope with pain.
3. Prevent complications of labour for the client and infant.
▪ Assess urinary bladder; catheterize as needed.
▪ Assess maternal vital signs, including temperature, pulse,
respiratory rates, and blood pressure.
▪ Check maternal urine for acetone (an indication of dehydration
and exhaustion).
▪ Assess condition of foetus by monitoring FHR, fetal activity, and
colour of amniotic fluid.
4. Provide physical and emotional support.
▪ Promote relaxation through bathing and keeping the client and
bed clean, back rubs, frequent position changes (sideling),
walking (if indicated), and by keeping the environment quiet.
▪ Coach the client in breathing and relaxation techniques.
5. Provide client and family education.
Risk For Fluid Volume Deficit
Risk for fluid volume deficit: At risk for experiencing vascular, cellular, or
intracellular dehydration.
Risk factors
