Precipitating Factors: Oligohydramnios, Rupture of Membranes (ROM), ineffective bearing down techniques, Induction of labor, Placental anomalies, Cord

coil, Long/short cord, Post-term neonate, Gestational Diabetes, Pregnancy-Induced Hypertension, Twin Pregnancy, Breech Position

Knowledge deficit: appropriate bearing down technique

Oligohydramnios

Rupture of membranes

Amnioinfusion Hyperstimulation of the uterus compared from the normal

Induction of labor

Altered comfort: Pain

Decreased amniotic fluid inside the utero More space for the cord to move With each movement of the fetus and contraction of the uterus

With each contraction, blood vessels constrict

Fetus assumes or stays in an unfavorable position with each contraction

Inadequate blood flow to the placenta

Inadequate perfusion of the fetus

Pressure on the cord in the vaginal introitus by the fetal presenting part

Pressure on the cord against the uterine wall

Fetal distress

Cord compression Oxygen administration

Fetal hypoxia Inadequate oxygenation of the fetus Stimulation of the vagus nerve

Increases gastrointestinal motility and relaxation of the anal sphincter Passing out of meconium in the amniotic fluid or inside the utero Due to inadequate oxygenation, the fetus gasps for breath With the mouth open, meconium can be inhaled into the lungs Difficulty in breathing/no respiratory effort MECONIUM ASPIRATION Blockage of meconium aspirates in the lung parenchyma Inflammatory response Infection (Pneumonitis) Impaired gas exchange Antibiotics Meconium aspirates upon suctioning Risk for infection

Antibiotics

Crackles, wheezing upon auscultation Intubation, Suctioning

Ineffective airway clearance

Mechanical obstruction of the airway Less oxygen passes to the bronchioles or alveoli Obstruction of meconium in the alveolar-capillary membrane

Increased thickness in the alveolar-capillary membrane

Poor diffusion of CO2 into the alveoli Respiratory Acidosis

Poor diffusion of oxygen into the bloodstream PaO2 of less than 80 mm Hg SaO2 of less than 95%

Oxygen administration

PaCo2 of more than 45 mm Hg

If not corrected

Hypoxemia

Heart is forced to pump harder and faster

Ventilation-perfusion mismatch

Heart compensates through shunting blood to the vital organs Poor peripheral circulation

Pulmonary hypertension (Cor Pulmonale) Heart decompensate

Ineffective peripheral tissue perfusion

Shock

Fetal Death

LEGENDS: Signs and Symptoms Priority Nursing Diagnoses (mother) Priority Nursing Diagnoses (Newborn) Medical Management * Nursing Management: discussed w/each diagnosis