The Young Couple Has Come To The Clinic Concerned Abo 518467

The Young Couple Has Come To The Clinic Concerned Something Is Wrong

The young couple has come to the clinic concerned that something is wrong. At the last visit, ultrasound noted that the fetus was in a complete breech position. The woman has been experiencing contractions every 10 minutes lasting approximately 45 seconds. She feels the baby has not moved into the correct position. What assessments and concerns should the nurse address? What nursing diagnoses are appropriate for this couple? What expected outcomes should the nurse identify?

Paper For Above instruction

The scenario presented involves a young pregnant woman with a fetus in a breech presentation, coupled with ongoing contractions. This situation demands a thorough assessment, appropriate nursing diagnoses, and clearly defined expected outcomes to ensure maternal and fetal well-being. This paper will explore the key assessments, primary concerns, suitable nursing diagnoses, and the anticipated outcomes relevant to this clinical situation.

Assessment and Concerns

The initial step in caring for this patient involves comprehensive assessment. The nurse should begin with maternal vital signs, fetal heart rate monitoring, and a detailed description of contraction patterns. The patient's recent ultrasound indicating breech presentation necessitates confirmation and evaluation of fetal position through physical examination and possibly additional imaging. It is vital to assess uterine activity, including the intensity, frequency, and duration of contractions, as well as maternal comfort, hydration status, and signs of labor progression or complication.

Fetal well-being is paramount, making fetal heart rate monitoring essential. The nurse should assess for decelerations or abnormal variability that might indicate fetal distress. Additionally, evaluating for signs of placental insufficiency or cord compression forms part of comprehensive fetal assessment. It is also critical to observe for maternal signs of preterm labor such as increased contractions, vaginal bleeding, or fluid leakage.

Concerns include the risk of fetal injury due to breech position, especially with ongoing contractions, which may precipitate labor or complicate delivery. The continued contractions could threaten placental perfusion or lead to preterm labor, especially if contractions intensify. Understanding whether the fetus can safely undergo external cephalic version (ECV) or whether the delivery plan should be a cesarean section is crucial.

Nursing Diagnoses

Based on the assessment, appropriate nursing diagnoses include:

1. Risk for fetal position-related complication related to breech presentation.

2. Risk for preterm labor related to contractions and pregnancy status.

3. Anxiety related to concern about fetal position and potential delivery complications.

4. Impaired fetal oxygenation related to uterine contractions and abnormal fetal position.

5. Deficient knowledge regarding pregnancy status and delivery options.

These diagnoses guide the development of individualized care plans focusing on safety, education, and emotional support.

Expected Outcomes

The pivotal outcome is the maintenance of maternal and fetal health. Specific expected outcomes include:

- The fetus remains in a safe position until delivery, with no signs of fetal distress.

- Maternal contractions are controlled, reducing preterm labor risk.

- The mother exhibits understanding of her condition, potential interventions, and delivery options.

- The mother reports reduced anxiety levels due to comprehensive education and emotional support.

- Fetal heart tones remain within normal limits, indicating fetal well-being.

- No maternal or fetal complications arise during observation and management.

Achieving these outcomes involves continuous monitoring, patient education, and readiness to implement interventions like external cephalic version or preparing for cesarean delivery if needed.

Interventions and Management Strategies

Interventions include close monitoring of fetal heart rate patterns, assessment of contraction patterns, and maternal hydration to inhibit preterm labor. The nurse should also provide education about breech presentation and possible management options. If appropriate, external cephalic version may be attempted under medical supervision to turn the fetus to a cephalic position, thus increasing the likelihood of vaginal delivery. If version is unsuccessful or contraindicated, planning for cesarean delivery becomes a priority.

Effective communication is essential to alleviate maternal anxiety. Techniques such as providing detailed explanations, reassurance, and involving the patient in decision-making foster trust and cooperation. Coordination with the healthcare team ensures timely intervention should labor progress or complications develop.

Conclusion

Managing a pregnant woman with breech presentation and preterm contractions requires a multidimensional approach emphasizing assessment, diagnosis, and intervention. The nurse's role encompasses vigilant monitoring, patient education, emotional support, and preparation for delivery. Clear objectives related to maternal and fetal safety form the cornerstone of effective care, ensuring positive outcomes for both mother and fetus.

References

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