Diseases & Disorders - A Nursing Therapeutic Manual : a by Marilyn Sommers

By Marilyn Sommers

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If a vaginal delivery is indicated and no regular contractions are occurring, the physician may choose to infuse oxytocin cautiously in order to induce the labor. If the patient’s condition is more severe, aggressive, expedient, and frequent assessments of blood loss, vital signs, and fetal heart rate pattern and variability are performed. Give lactated Ringer’s solution intravenously (IV) via a large-gauge peripheral catheter. At times, two intravenous catheters are needed, especially if a blood transfusion is anticipated and the fluid loss has been great.

COMPLICATIONS. 4°F, or persistent feelings of depression. HOME CARE. Teach the patient to avoid strenuous activities for a few days. Encourage the patient to use peripads instead of tampons for light vaginal discharge to decrease the likelihood of an infection. Explain that the patient should avoid intercourse for at least 1 week and then use some method of birth control until a future pregnancy can be discussed with the physician. Follow-up is suggested. A phone call to the patient on her due date will demonstrate support and provide an outlet for her to express her grief.

PHYSICAL EXAMINATION. 4°F if a maternal infection is present. In addition, pallor, cool and clammy skin, and changes in the level of consciousness are symptoms of shock. Examine the patient’s peripad for blood loss, and determine if any tissue has been expelled. Sometimes tissue can be observed at the introitus, but do not perform a vaginal examination if that situation occurs. PSYCHOSOCIAL. Assess the patient’s emotional status, as well as that of the baby’s father and other family members. Often this hospital admission is the first one for the patient, and it may cause anxiety and fear.

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