Labor Dystocia, Prolapsed Umbilical Cord, Cesarean Section - Maternity Nursing | @LevelUpRN

Summary

In this educational video, Meris from Level Up RN discusses labor dystocia, prolapsed umbilical cords, and C-section births, using maternity flashcards for reference. She explains causes of dystocia, such as fetal macrosomia and maternal fatigue, and outlines interventions like ambulation and position changes. Meris addresses shoulder dystocia as a medical emergency, detailing the application of pressure on the suprapubic region. She also covers the management of prolapsed umbilical cords, emphasizing the importance of reducing cord compression and proper positioning. Lastly, she touches on C-sections, including anesthesia types and nursing care, highlighting the significance of prompt and appropriate interventions for maternal and fetal well-being.

Takeaways

• 😌 Dystocia refers to a prolonged or difficult birth, which can be caused by factors such as fetal macrosomia, maternal fatigue, uterine abnormalities, cephalopelvic disproportion, fetal malpresentation, and anesthetic use.
• 🚶‍♀️ To manage labor dystocia, encourage the patient to ambulate or change positions, if possible, to facilitate fetal movement and rotation.
• 🆘 Shoulder dystocia is a medical emergency where the fetal shoulder is stuck on the maternal pelvis, potentially causing nerve, muscle, or bone damage.
• 🤲 For shoulder dystocia, the nurse may apply pressure on the suprapubic region to help dislodge the stuck shoulder.
• 🤰 Prolapsed umbilical cord is a serious condition where the cord protrudes through the cervix before the baby, risking fetal hypoxia and distress.
• 🙏 In the case of a prolapsed umbilical cord, the nurse should call for assistance, apply sterile gloves, and attempt to lift the fetal presenting part off the cord to reduce compression.
• 🧘‍♀️ Positioning the mother in knee-chest or Trendelenburg position can help alleviate cord compression in a prolapsed umbilical cord scenario.
• 🛑 If a prolapsed umbilical cord is exposed, it should be covered with a warm, sterile saline-soaked towel to prevent drying and infection.
• ✂️ C-sections involve surgical delivery of the baby through an abdominal and uterine incision, with anesthesia options including spinal, epidural, or general anesthesia.
• 🩺 Risk factors for C-sections include labor dystocia, fetal malpresentation, failure to progress, fetal distress, and a history of previous C-sections.
• 💊 Post-C-section nursing care involves ensuring a patent IV, administering foley catheter, providing IV fluids, administering antibiotics and analgesics, and monitoring the incision site for signs of infection or complications.

Q & A

What is dystocia?

Dystocia refers to a prolonged or difficult birth, which can occur for multiple reasons such as fetal macrosomia, maternal fatigue, uterine abnormalities, cephalopelvic disproportion, fetal malpresentation, or anesthetic or analgesic use.

What are some signs and symptoms of labor dystocia?

Signs and symptoms of labor dystocia include lack of progress in dilation, no change in fetal station, and the fetus not descending.

How can a nurse help a patient experiencing dystocia?

A nurse can encourage the patient to ambulate or change positions if allowed, and if the goal is to move the baby from a posterior to an anterior position, the patient can be positioned on their hands and knees.

What is shoulder dystocia and why is it considered an emergency?

Shoulder dystocia occurs when the fetal shoulder gets stuck on the maternal pelvis, which can cause damage to nerves, muscles, and bones. It is a true emergency due to the potential for severe complications.

Where should a nurse apply pressure in the case of shoulder dystocia?

In the case of shoulder dystocia, a nurse should apply pressure on the suprapubic region, just above the pubic bone.

What is a prolapsed umbilical cord and why is it dangerous?

A prolapsed umbilical cord occurs when the cord protrudes through the cervix before the baby, which can lead to cord compression, fetal hypoxia, distress, and compromised fetal circulation.

How can a nurse identify a prolapsed umbilical cord?

A nurse can identify a prolapsed umbilical cord by seeing it or feeling it during a cervical check, and by observing variable decelerations in fetal heart rate monitoring.

What positions are indicated for a patient experiencing a prolapsed umbilical cord?

For a patient with a prolapsed umbilical cord, the nurse should position the mother in either the Trendelenburg or knee-chest position to use gravity to shift the baby off the cord.

How should a nurse care for an exposed prolapsed umbilical cord?

An exposed prolapsed umbilical cord should be covered with a warm, sterile, saline-soaked towel to protect it from drying out or exposure to germs.

What are the different types of anesthesia that can be used during a C-section?

The types of anesthesia that can be used during a C-section include spinal anesthesia, epidural anesthesia, and general anesthesia, depending on the situation.

What are some risk factors for a C-section?

Risk factors for a C-section include labor dystocia, fetal malpresentation, failure to progress, fetal distress, and a history of previous C-sections.

What are the common complications associated with C-sections?

Common complications associated with C-sections are hemorrhage and infection.

What is the nursing care for a patient after a C-section?

Nursing care after a C-section includes ensuring a patent IV, starting a foley catheter, running IV fluids, administering preoperative medications like antibiotics, providing analgesia for post-op pain, and assessing the incision site for signs of infection or other issues.