Question

Oxytocin Induction of Labor Secondary to Postdates (41 4/7 weeks)

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

#. Diagnosis - Pregnancy that persists beyond the 42nd week of gestation and is associated with placental changes that cause a decrease in the uterine-fetal circulation. This reduces the blood supply, oxygen, and nutrition for the fetus

#. Pathophysiology :-

-Not completely understood

-Associated with lack of usually high estrogen level in normal pregnancy

-Extrauterine pregnancy

#. Risk factors :-

-Nullipara between 15-20 years of age

-Multipara over 35 years of age

-Fetal adrenal hypoplasia

-Anencephalic fetus

#. Expected finding :-

-Oligohydramnios (if the placenta is not working well baby not peeing)

-Macrosomic infant (over cooked)

-High incidence of fetal heart rate baseline changes (tachycardia, variable decelerations) [makes sense if placental is wearing out, lack of oxygen]

-Meconium stained fluid

-Neonatal depression (again if placenta is not working, baby is not getting enough oxygen)

#. Diagnostic studies

-Biophysical profile

-Nonstress testing 2-3 times/week after 40 weeks gestation

#. Management

-Electronic fetal monitoring during labor

-Induction of labor after 42 weeks of gestation if cervix favorable (soft, with some effacement)

-Birth accomplished at 43 weeks by induction or cesarean section if vaginal delivery not possible

#. Nursing Management :-

Carefully assess the fetus to identify risk. Perform a careful risk assessment upon admission. Closely monitor fetal status.

Prevent birth complications. Assist with induction of labor. Prepare for a difficult delivery.

Provide physical and emotional support.

Provide client and family education

#. Maternal complications of post term delivery

1. Vaginal trauma

2. Labor dystocia

3. Increase rate of C/S

Fetal complication of being post-term

Macrosomia

Still birth 1/300

Oligohydramnios

Shoulder dystocia

Meconium aspiration syndrome

Dysmaturity