The Nursing Intervention In Pregnancy And Childbirth
Table of Contents
Family-Centered Nursing interventions
Labs and Diagnostics
Nursing Process Plan
In the pathophysiology, pregnancy involves fertilization with sperm. The fallopian tubes are then fertilized. The fertilized embryo travels from the fallopian tube to the uterus. It will implant in 7-10 days. The zygote will become an embryo once it has been implanted into the uterus. This stage is between three and eight weeks following fertilization. After this, an embryo turns into a foetus. It lasts up to eight weeks from fertilization.
Standard practice is to perform vaginal and electronic fetal-heart monitoring during labor. To assist with vaginal birth, vacuum extractions or forceps are available. To make delivery easier, an episiotomy may be performed. A pain-relieving epidural may be used to relieve labor pain. Oxytocin, which is administered after delivery of the placenta, can contract the uterus.
Family Centered Nurse InterventionsFamily-centered nursing interventions are based on how family members interact with the pregnant woman. Nurses are encouraged to observe the bonding that occurs between father and son and mother. Nurses should assess eye contact, kissing, fondling, talking, and smiling to the baby, as well as if there are any negative statements. In order to promote bonding between mother and child, nurses must ensure that the parents are comfortable. They should also provide information on skin-toskin care and praise good parenting behaviors. In order to see and encourage a healthy relationship between parents and children, it is crucial that nurses help them establish one. Nurses shouldn’t forget the role of the father. They can help identify it. Parents should be taught to give time to their older siblings, because this can make them feel isolated. In this stage, children are able to notice the change of their mother. The environment must remain unchanged. Nurses can also help parents include the child at feeding times for infants, praise them when they behave appropriately and give small gifts to make sure the child is not left out. It is important to include all family members in the process of adjusting to the new infant (Perry et.al.,2014).
Many medications are administered to another during childbirth. Topical spray Benzocaine-menthol can be used to treat pain levels ranging from 1-3. This medication helps to reduce pain and relieve itching following a vaginalbirth. Docusate Sodium, a stool-softener, is prescribed to the patient until he or she has a bowel motion. It is used to relieve constellations, help induce bowel movements, and prevent hard and dry stools. Ibuprofen, a non-steroidal antiinflammatory drug, reduces hormones that can cause pain and inflammation. The medication should be taken as needed with food and only if the pain score is less than 5. Oxycodone-Acetaminophen is a combination of oxycodone, which is an opioid, and acetaminophen, which is an analgesic to relieve moderate to severe pain. The dose is increased if pain is higher than 5. The maximum dose for adults is 4000 mg. For 24 hours. Witch Hazel Glycerin is made up of witch hazel and glycerin. Witch hazel is an astringent that shrinks tissues, relieves irritation, and itching. It is used to treat hemorrhoids or relieve discomfort from childbirth. Zolpidem works by affecting the unbalanced brain chemicals which can lead to insomnia. It is administered at night for insomnia. Oxytocin causes contractions in the uterus. It stimulates labor and increases contractions of labor (Adams Holland & Urban 2017).
Labs, DiagnosticsHuman Gonadotropin is a biological marker that can be used to detect pregnancy. Pregnancy test recognizes hCG. Early detection of hCG in blood or urine can occur as early at implantation. Serum tests are used to test for a pregnancy using urine, while home pregnancy kits collect urine. Amenorrhea is the first sign of pregnancy that a woman detects. The objective and positive signs that a woman is pregnant are hearing fetal heart sounds, seeing the fetus in motion, and feeling its movement (Perry, et.al., 2014). Complete blood counts and RBC antibody screens are performed. These labs check for hemorrhage and infection. RBC antibodies and screens are used to identify maternal blood types in the event that blood products need to be administered.
Needs of the patient After delivery, the mother undergoes a number of physical changes. Involution, or the return to a non-pregnant uterus state is what we call. This is a self-destructive process that destroys excess hypertrophied tissue. Lochia or post-birth uterine bleeding, is three distinct stages that occur as the woman returns to her non-pregnant body. After pregnancy, the abdominal wall relaxes for about two weeks but then returns to its original shape. Striae are often still visible after pregnancy. Milk production causes breasts to become heavier and fuller after delivery. Also common are varicosities and haemorrhoids. After birth, ovulation and periods return. For mothers to return to normal bladder and bowel function, they need to rest, get some exercise, be comfortable, and receive education about breastfeeding.
Psychosocial needs are also present in mothers. The importance of ongoing support and the satisfaction of their emotional requirements is crucial. The nurses must assess the sexuality and self-image of mothers. Parents may be reluctant to have sex again for fear of further peritoneal damage or pain. This is a topic that should be discussed with the mother. The nurse will also need to assess how the mother is adapting to being a parent, the reaction of the baby, and establishing a good relationship with her infant. Postpartum depression can affect mothers. It’s not clear what causes postpartum depression, but it could be due to being emotionally or physically vulnerable, as well feeling deprived (Perry and al., 2013).
Health PromotionSuch health promotion includes breastfeeding, promoting normal bowel and urinary function, promoting exercise and rest, promoting nutrition and promoting vaccinations. This is the time to emphasize the importance ambulation has in preventing venous thromboembolism. This helps to increase blood flow, which prevents stagnation. For mothers to avoid dizziness and fainting it is essential to inform them about orthostatic hypertension. The nurses should encourage patients to exercise, and they can teach them postpartum muscle strengthening exercises. Nurses could teach abdominal breathing, leg rolls, buttocks lifting, and kegels. Nurses can educate their patients about the depressive effects that may result from postpartum tiredness. Sleep aids can include back rubs, comfort measures, and medication. Support can reduce anxiety. Nursing staff can also educate patients on nutrition. Iron supplements and prenatal vitamin should be continued by patients for at least six weeks following birth. The patient must follow a healthy diet to help prevent anemia or constipation. This will also support healing, and encourage breastfeeding.
Nurses may also instruct patients on how to maintain normal bladder or bowel activity. Nurses accompany patients for their very first voiding following birth. All interventions that encourage urination include running water, using a warm squeeze bottle of water on the abdomen, and placing your hand in warm bath water. Regular bowel movements can be promoted by promoting hydration, fiber intake, and ambulation. It is also important to encourage breastfeeding. Lactation consultants and nurses help mothers by providing breastfeeding instruction and teaching techniques. The ideal time to start breastfeeding is between one and two hours following birth. Vaccinations should also be given to future mothers. Rubella vaccination is recommended to prevent future rubella infections. Varicella can also be administered. Tetanus-Diptheria-Acellular Pertussis canine protects the mother form pertussis and decreases the risk of the infant contracting pertussis. Rh immune serum can be given to Rh-negative mothers who have received a transfusion of Rh positive red blood cells from their infants.
Risk of constipation related to hemorrhoids, as evidenced by lack of bowel movements
Interventions. Nurses can administer prescribed medication like Colace, which softens stool and makes defecation easier. The nurse may encourage the patient walk in order for peristalsis to be promoted. The nurse must encourage the patient to drink from 2,000 to 3, 000 mL daily in order to maintain soft stool. Patients should be taught to consume at least 20 grams fiber per day in order to bulk up their stool and make defecation more comfortable. Warm soaks in the tub can relax muscles. Witch-hazel pads are good for hemorrhoids. Allow the patient to sit up straight when going to the toilet to encourage defecation.
Expected results. The patient will have had a bowel move within two to four days of the delivery. Constipation will not cause pain greater than 3 on a scale or increase in discomfort. Patient will engage in interventions to alleviate constipation.
Acute pain related to postpartum physiological changes (Hemorrhoids or Breast Engorgement) as evidenced by a 4 on the Pain Scale
Interventions. In order to determine the best interventions, it is important that the nurse first determines where, what kind of pain, and how severe it is. Administer the appropriate pain medication to relieve pain. The nurse can apply ice packs on the perineum in order to reduce discomfort, edema and irritation caused by hemorrhoids and trauma during birth. To reduce edema while promoting circulation and reducing discomfort, teach the use of cool sitzbaths in the first 24 hrs and then warm sitzbaths after that. Witch hazel compresses can be used to reduce swelling. Dermoplast, a topical spray for nerves, can be used as a tool to help reduce peripheral response. When breasts become engorged from feeding, mothers should apply ice to reduce swelling. This will promote milk production. Warm showers are also a good way to encourage lactation. Nurses can teach their patients to apply expressed milk to sore nipples in order to speed up healing. Comfort can be provided by hydrogel pads. Breast shells are a good way to reduce irritation. You can reduce swelling by using ice, breast binders or support bras. Nurses should monitor the baby’s position and latching pattern during breastfeeding in order to avoid damaging nipples (Perry, et.al., 2014).
Expected results Signs of reduced discomfort will be seen in the patient. The patient will report a pain rating of less than 3. Edema should decrease after interventions are used (Perry et.al. 2014).
“Feeling tired more often” is an indication of a disturbed sleeping pattern related to discomfort.
Interventions. Nurses should compare the patient’s normal sleep schedule with what she is currently experiencing to identify the cause of the sleeping problems. For optimal sleeping conditions, the nurse should provide an environment with darkness, quietness, warm room temperature, and decreased stimulation. In addition to back massages, warm milk and soothing music, the nurse could also teach relaxation techniques, as well as provide soothing music. To improve the quality of your sleep, you should avoid caffeine, fluids and extreme activities, as well as lights, noises and light sources. Give pain medication or sleep medicine to improve sleep quality. Encourage the patient (or infant) to nap during infant’s nap time to reduce fatigue.
Expected results. The patient will sleep for 7-8 hours per day. The patient will sleep uninterrupted for periods. Patient will feel rested upon waking.