NR 327 EDAPT INTRAPARTUM PERIOD NURSING CARE 2024

EDAPT INTRAPARTUM PERIOD NURSING CARE The birthing process represents a major life event for clients and their families, regardless of the number of previous deliveries. The nurse is responsible for caring for the pregnant woman, family, and fetus throughout labor and delivery. When admitting a client to the labor and delivery unit, which is the priority assessment? The assessment and evaluation of contractions are necessary to establish baseline data. Without adequate frequency and duration of contractions, labor may fail to progress. Though it is important to understand the client's pregnancy history, as this may impact the speed and progression of labor, it is not the priority assessment. While having a labor partner is helpful as labor progresses, it is not the priority assessment during admission. Documenting the time of last meal is important, especially if cesarean birth is necessary. However, this is not the priority assessment during admission. The nurse is caring for a client in labor who is receiving oxytocin. Which assessment finding requires immediate action? Uterine tachysystole (hyperstimulation) is defined as more than 5 contractions in 10 minutes (or contractions closer than 2 minutes in frequency). Tachysystole can result in decreased fetal oxygenation and requires immediate action. Urine output of at least 30 mL/hour is not concerning. Fetal heart rate between 110-160 bpm with moderate variability is normal. Contraction duration of 50-60 seconds is an indication for oxytocin use. What are indications for labor induction? Select all that apply. Indications for labor induction may include:  Maternal factors:  premature or prolonged rupture of membranes  preeclampsia/eclampsia  history of fetal stillbirth or demise  diabetes mellitus  history of precipitous (less than 3 hours) labor  chorioamnionitis  oligohydramnios  post-term gestation  Fetal factors:  intrauterine growth restriction (IUGR)  non-reassuring fetal heart rate and pattern  fetal complications, such as erythroblastosis fetalis and hydrops  significant congenital anomalies Maternal request for convenience is not an indication for induction of labor. Labor induction is contraindicated with placenta previa. A cesarean birth is necessary. Maternity nursing is a highly specialized area of nursing, which includes terminology that may be new. It may be helpful to keep a reference guide handy for use in the clinical area as you become familiar with maternity nursing terms. AROM: Augmented (also called artificial) rupture of membranes Cephalic Presentation: Fetus positioned head down; most common fetal presentation Dilation: Progressive opening of cervix caused by uterine contractions; 0–10 cm Effacement: Shortening and thinning of the cervix within stage one of labor EFM: Electronic fetal monitoring Engagement: Fetal presenting part reaches true pelvis FHR: Fetal heart rate Fundus: Upper aspect of the uterus Intrapartum: Onset of labor to birth Lightening: Descent of fetal presenting part into the pelvic cavity, often 38 weeks gestation (or 2 weeks before labor onset in primiparas) NST: Nonstress test; fetal assessment for well-being, (2) accelerations documented with 15 bpm above baseline × 15 seconds in length minimum = (+) NST PROM: Premature rupture of membranes; no contraction or no dilation noted, but SROM occurred SROM: Spontaneous rupture of membranes Station: Relation of the presenting part to the ischial spines of maternal pelvis SVE: Assessment performed by RN to determine cervical dilation, station, and effacement