System disorder umbilical cord prolapse PDF

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Summary

system disorder...

Description

ACTIVE LEARNING TEMPLATE:

System Disorder

ST UDENT NAME _____________________________________

Umbilical cord prolapse DISORDER/DISEASE PROCESS __________________________________________________________

Alterations in Health (Diagnosis) Umbilical cord prolapse

Pathophysiology Related to Client Problem Cord prolapse has been defined as the descent of the umbilical cord through the cervix alongside (occult) or past the presenting part (overt) in the presence of ruptured membranes.

REVIEW MODULE CHAPTER ___________

Health Promotion and Disease Prevention Umbilical cord prolapse cannot be prevented

ASSESSMENT

SAFETY CONSIDERATIONS

Risk Factors

Expected Findings

ruptured membranes, abnormal fetal presentation, presenting part high in pelvis, preterm labor, small for gestational age, unusually long umbilical cord, multi-fetal pregnancy, placenta previa

Laboratory Tests

The most obvious symptom of a prolapsed umbilical cord is seeing or feeling the cord before the baby is delivered. Fetal distress from lack of oxygen can also be observed as a sudden and prolonged fetal heart rate deceleration on the fetal monitor (bradycardia)

Diagnostic Procedures

Umbilical cord prolapse is diagnosed by seeing or palpating the prolapsed cord on pelvic exam. In addition, the baby may have an abnormal fetal heart rate known as bradycardia (a heart rate of less than 120 beats per minute

Umbilical cord prolapse is diagnosed by seeing or palpating the prolapsed cord on pelvic exam. In addition, the baby may have an abnormal fetal heart rate known as bradycardia

PATIENT-CENTERED CARE

Nursing Care Notify HCP - Put on sterile gloves, insert two fingers into vagina and remove pressure off the cord - Have the mother lay in a knee-chest position; or trendelburg position - Apply sterile soaked saline ONLY if the cord is protruding from the vagina - give oxygen - prepare for emergency C/S

Therapeutic Procedures Umbilical cord prolapse is an acute obstetric emergency that requires immediate delivery of the baby. The route of delivery is usually by cesarean section. The doctor will relieve cord compression by manually elevating the fetal presentation part until cesarean section is performed.

ACTIVE LEARNING TEMPLATES

Pressure of the presenting part on the cord may restrict umbilical cord blood flow resulting in acute fetal heart rate changes, which, if persistent hypoxia leads to asphyxia, artificial AROM should be avoided

Complications Medications apply oxygen - increase fluids - administer ephedrine for severe hypotension

Client Education Provide information about the urgency of the situationm and probable need for C section, offer postpartum debriefing to the woman and support person

Interprofessional Care Obstetrician, anaesthesiologist, OB nurse,

a diagnosis of umbilical cord prolapse carries a risk of fetal mortality. Though rare, surviving infants may develop complications secondary to asphyxia, including neonatal encephalopathy and cerebral palsy

THERAPEUTIC PROCEDURE

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