Complications of pregnancy and labor and delivery
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| Threatened abortion | Spotting and cramping without cervical changes.
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| Inevitable abortion | Spotting and cramping and the cervix begins to dilate and efface.
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| Incomplete abortion | Loss of some of the products of conception occurs with part of the products retained.
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| Missed abortion | Products of conception are retained in utero after fetal death.
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| DIC | Disseminated intravascular coagulation- maternal condition in which the clotting cascade is activated, resulting in the formation of clots.
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| Predisposing conditions for DIC | Abruptio placentae, amniotic fluid embolism, gestational hypertension, intrauterine fetal death, liver disease, sepsis.
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| Nursing interventions for DIC | Remove the underlying cause, monitor vital signs, assess for bleeding and signs of shock, prepare for oxygen therapy, volume replacement, monitor urine output and maintain at 30 mL/hr
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| Dystocia | Difficult labor that is prolonged; caused by uterine contractions, the fetus or the bones and tissues of the maternal pelvis.
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| Assessment findings of dystocia | Excessive abdominal pain, abnormal contraction pattern, fetal distress, maternal or fetal tachycardia, lack of progress in labor.
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| Nursing interventions for dystocia client | Assess FHR, monitor uterine contractions, monitor maternal temp and HR, assist with pelvic exam, US, admin prophylactic antibiotics, admin IV fluids, monitor I&O,perform fetal monitoring if pitocin is prescribed, provide rest, assess for prolapse of cord.
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| Precipitous labor and delivery | Labor lasting less than 3 hrs.
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| Nsg. interventions for precipitous labor | Stay with the mother, encourage the mother to pant between contractions, prepare for rupturing membranes, do not try to keep the fetus from being delivered.
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| Preterm labor | Occurs after the 20th week but before the 37 th week of gestation.
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| S/S preterm labor | Uterine contractions, abdominal cramping, low back pain, pelvic pressure, change in character and amt of usual discharge, rupture of amniotic membrane
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| Nsg interventions for pre term labor | Focus on stopping the labor, restrict activity, identify and treat infection, ensure hydration, maintain bed rest and a lateral position, monitor fetal status, admin fluids.
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| Premature rupture of membranes | Spontaneous rupture of the amniotic membrane before the onset of labor.
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| Rupture of uterus | Complete or incomplete separation of the uterine tissue as a result of a tear in the wall of the uterus from the stress of labor. fetus can be palpated outside the uterus.
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