Question

Induction of Labor Secondary to Postdates

WHAT ARE THE:

Alterations in Health (Diagnosis):

Pathophysiology Related to Client Problem:

Health Promotion and Disease Prevention:

Risk Factors:

Expected Findings:

Laboratory Tests:

Diagnostic Procedures:

Nursing Care:

Therapeutic Procedures:

Medications:

Client Education:

Interprofessional Care:

Safety Considerations:

Complications:

Answer 1

INDUCTION OF LABOUR SECONDARY TO POSTDATES:POSTDATE PREGNANCY REFERS TO THE PREGNANCY THAT HAS GONE BEYOND OR EXCEEDED 42 WEEKS OF PREGNANCY.

1. ALTERATIONS IN HEALTH ( DIAGNOSIS):AS THE PREGNANCY IS DELAYED, IT MAY LEAD TO SEVERAL NEONATAL MORTALITY, MORBIDITY, AND MATERNAL MORTALITY. THE MOST COMMON DIAGNOSIS ARE STILLBIRTH, INTRAUTERINE FETAL DEATH,LABOUR DYSTOCIA ,SEVERE PERINEAL LACERATIONS, CHOREOAMNIONITIS,POSTPARTUM HEMORRHAGE IN MOTHER.

2. PATHOPHYSIOLOGY RELATED TO THE CLIENT PROBLEM:

• THERE OCCURS A SLOW INCREASE IN THE CORTICOTROPHIC RELEASING HORMONE (CRH) WHICH INFLUENCES THE LENGTH OF GESTATION DUE TO AN INHERITED PRESDISPOSITION IN THE GENE POLYMORPHISM.

3.HEALTH PROMOTION AND DISEASE PREVENTION:

• HEALTH EDUCATION TO THE CLIENT ABOUT MEMBRANE SWEEPING OR STRIPPING EVEN BEFORE ADMISSION TO THE HOSPITAL WHICH INITIATES THE INDUCTION OF LABOUR AS THERE IS AN INCREASE IN THE PROSTAGLANDIN PRODUCTION.
• IT CAN BE PREVENTED BY THE INDUCTION OF LABOUR AT TERM.
• SEXUAL INTERCOURSE WHICH FACILITATES INDUCTION OF LABOUR.
• ANOTHER NON-MEDICAL INTERVENTION IS BREAST STIMULATION.

4.RISK FACTORS:

• STILL BIRTH
• INTRAUTERINE FETAL DEATH DUE TO FETAL ASPHYXIA.
• POSTPARTUM HEMORRHAGE
• ENDOMETRITIS
• LABOUR DYSTOCIA.
• SEVERE PERINEAL LACERATIONS.
• MECONIUM ASPIRATION SYNDROME.

5.EXPECTED FINDINGS:

• .EXCESSIVELY LARGE UTERUS
• MECONIUM STAINED FLUID.

6.LABORATORY TESTS:

• CONTRACTION STRESS TEST
• NON STRESS TEST

7.DIAGNOSTIC PROCEDURES:

• ULTRASOUND FOR BIO[PHYSICAL PROFILE.
• CONTRACTION STRESS TEST
• FETAL HEART RATE MONITORING.

8. NURSING CARE:

• ASSESSMENT OF FETAL STATUS AND CLOSE MONITORING OF THE VITALS.
• PROVIDE EMOTIONAL SUPPORT
• PREPARATION OF DIFFICULT LABOUR.

9.THERAPEUTIC PROCEDURES:

• START OF A FORMAL INDUCTION OF LABOUR

10.MEDICATIONS:

PROSTAGLANDINS TO INITIATE CERVICAL RIPENING

11.CLIENT EDUCATION:

• BREAST STIMULATION.
• MEMBRANE STRIPPING.
• SEXUAL INTERCOURSE.

12.INTERPROFESSIONAL CARE:

• ACUPUNCTURE.
• PEDIATICIANS.

13.SAFETY CONSIDERATIONS:

• PREPARATION FOR DIFFICULT LABOUR.
• READY FOR CESAREAN SECTION IF REQUIRED.
• AVAILABILITY OF COMPATIBLE BLOOD IF POSTPARTUM HEMORRHAGE OCCURS.

14.COMPLICATIONS:

• LABOUR DYSTOCIA.
• SEVERE POSTPARTUM HEMMORHAGE.
• SEVERE PERINEAL LACERATIONS.
• ENDOMETRITIS.
• FETAL ASPHYXIA