What should take place before external cephalic version? - ANS--sign informed consent
-ultrasound
-Non-stress test
-Give Rhogam at 28 weeks if the mother is Rh-
-Administer IV fluid and tocolytics to relax the uterus to permit easier manipulation
Nursing care after external cephalic version - ANS--monitor FHR tracings for
bradycardia and variable deceleration during and for 1 hr after
-monitor vitals signs
-assess for hypotension that indicates vena cava compression
-monitor for pain
-give Rhogam if mom is Rh-
When would a cervical ripening agent be discontinued? - ANS-once the mother is 3cm
dilated and 30% effaced
, How many cm would a primipara be expected to dilate per hour? - ANS-1 cm
How many cm would a multipara be expected to dilate per hour? - ANS-1-1.5 cm
What is the minimum frequency for cervical exams? - ANS-every 4 hours
A bishop score of less than _____ for a primipara is an indication for cervical ripening -
ANS-10
A bishop score of ____ or more for a primipara is an indication for oxytocin - ANS-10
A bishop score of less than _____ for a multipara is an indication for cervical ripening -
ANS-8
A bishop score of ____ or more for a multipara is an indication for oxytocin - ANS-8
A bishop score of _____ at 39 weeks is an indication of successful induction of labor -
ANS-8
Name 2 chemical cervical ripening agents - ANS-misoprostol and dinoprostone
Nursing actions for cervical ripening - ANS--obtain informed consent
- obtain FHR and contraction patterns before and after
-assist the mother to void prior to the procedure
-document the number of dilators or sponges used
- maintain the mother in a side-lying position
-monitor for tachysystole and fetal distress
nursing actions of fetal distress occurs - ANS--administer oxygen at 10L/min
-reposition mother onto left side
-Increase rate of IV maintenance fluid
- notify the provider
Indications for induction of labor - ANS-- post-term pregnancy (42+ weeks)
- dystocia (prolonged, difficult labor)
- prolonged rupture of membranes
-IUGR
- maternal medical complications (Rh-isoimmunization, DM, pulmonary disease,
gestational hypertension)
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