Student Nurse Laura

Orem – "creative effort of one human being to help another human being."

Dystocia

Posted by Laura on March 14, 2010

Dysfunctional Labor is described as hypertonic or hypotonic increases a woman’s risk for uterine dystocia.

Dysfunctional Labor .pdf

Prolonged – Nursing Diagnoses:

  • Risk for infection RT – PPROM,  – operative procedures
  • Ineffective individual coping RT – exhaustion, – pain, inadequate support system
  • Risk for maternal or fetal injury RT – interventions implemented for dystocia       

                Interventions:

  • coach mother in bearing down w/contractions, assist w/relaxation between UCs
  • Position mother in favorable position for pushing
  • Reduce epidural infusion rate
  • Prepare for CS if nonreassuring fetal status occurs
Precipitous – Nursing Diagnoses:

  • Powerlessness RT – loss of control
  • Ineffective individual coping RT –  pain, inadequate support system
  • Risk for infection RT – PPROM, 
Hypotonic – Nursing Diagnoses:

  • Risk for infection RT – PPROM,  – operative procedures
  • Ineffective individual coping RT – exhaustion             

                Interventions:

  • Perform ultrasound/Radiographic exam to rule out CPD, assess FHR, characteristics of AF if ruptured, and maternal well-being
  • If above findings are normal, then – ambulation, position changes hydrotherapy, AROM, Oxytocin infusion
Hypertonic – Nursing Diagnoses:

  • Powerlessness RT – loss of control
  • Ineffective individual coping RT – exhaustion, –    pain  

                Interventions:

  • Initiate therapeutic rest measures.  – Analgesics if no ROM or cephalopelvic disproportion not present. (morphine, nalbuphine, meperidine)
  • Relieve pain to permit mother to rest
  • Assist with measures to enhance rest & relaxation(hydrotherapy)

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