75. NURSING DIAGNOSES-СУВИЛАХУЙН ОНОШ
A. Anxiety related to medication and fear of
outcome of pregnancy Түгшүүр нь
жирэмслэлтийн үз дүнгээс айх болоод
эмтэй холбоотой
B. Diversional Activity Deficit related to
prolonged bed rest
76. NURSING INTERVENTIONS-СУВИЛАХУЙН
ХЭРЭГЖҮҮЛЭЛТ
A. Decreasing Anxiety Санаа зовнилыг багасгах нь
1. Provide accurate information on the status of the fetus
and labor (contraction pattern). Ураг болоод
төрөлтийн талаарх тодорхой мэдлэгийг өгөх
2. Allow the woman and her support person to verbalize
their feelings regarding the episode of preterm labor
and the treatment. Эхийг хамт асарч буй хүнтэй
нь дутуу төрөлтийн, эмчилгээний мэдрэмж
ярих хийгээд хуваалцах боломж олгох.
3. If a private room is not used, do not place the woman
in a room with a woman who is in labor or who has lost
an infant. Тусгай өрөө байхгүй бол эхийг саяхан
хүүхдээ алдсан эх, эсвэл төрөх дөхөж буй
ээжтэй нэг өрөөнд оруулахгүй байх
4. Encourage relationship with other patients who are
also e
77. B. PROMOTING DIVERSIONAL ACTIVITIES
1. Determine quiet craft activities that can be done in bed.
Хэвтэрийн дэглэмд байлгах үед эхийг гараар
хйиж болох бүтээлч үйл ажиллагаанд уриалах
2. Provide radio, books, and television. TV, ном,
хөгжмөөр эхийн хангах
3. Encourage visits from family, especially other children
and friends. If possible encourage them to bring in
favorite foods for the woman and to dine as a family.
Эргэлтээр хүмүүсийг ирүүлэхийг дэмжих тэр дундаа
өөр бусад хүүхдийг оруулах, эхийн дуртай хоолыг
нь авчруулан гэр бүлээрээ хамт хооллохыг нь
зөвшөөрөх
4. Encourage other family activities, such as helping with
homework. This will assist on maintaining the family unit.
Гэр бүлээр хийж болох зүйлээр
дэмжих(хүүхдийнхээ гэрийн даалгаварыг нь
хийлгүүлэх боломжыг олгох)
78. PATIENT EDUCATION/HEALTH MAINTENANCE
1. Educate the woman about the importance of continuing the pregnancy
until term or until there is evidence of fetal lung maturity. Ургийн
уушигны хөгжил бүрэн хөгжих үе хүртэл эхийг хэвтэрийн
дэглэмээ сайн сахин тээлтийн бүрэн хугацаагаа гүйцээхийн
чухалыг ойлгуулах
2. Encourage the need for compliance with a decreased activity level or
bed rest, as indicated. Хөдөлгөөнийг нь хязгаарлаж өгсөн журмыг
баримтлан хэвтэрийн дэглэм сахиулах
3. Teach the woman the importance of proper nutrition and the need for
adequate hydration, at least 8 glasses of fluids a day. Хоол тэжээлийн
тэжээллэг байдлыг болоод өдөрт доод тал нь 8 аяга ус ууж
заншихыг зааж өгөх
4. Instruct the woman not to engage in sexual activity. Бэлгийн
харьцаанд орж болохгүйг анхааруулна.
5. Teach the woman the signs and symptoms of infection and to report
them Халдварын шинж тэмдэгийн илрэлийг зааж өгөн ямар нэг
байдлаар энэ бүхэн илэрвэл яаралтай эмчид мэдэгдэхийг хэлж
тайлбарлаж өгөх
Notas do Editor
PROM at term may result from stretching of the membranes and fetal movements that cause the membrane to weaken.
. Cord may be seen protruding from vagina or palpated in the vagina or cervix.
2. With compression, fetal heart rate pattern may show variable decelerations with contractions or between contractions; often fetal bradycardia is present.
3. If the cord is exposed to cold room air, there may be a reflex constriction of the umbilical blood vessels that further restricts the oxygen flow to the fetus.
Observe fetal heart rate deceleration.
2. Identify complete or forelying cord prolapse with a vaginal examination by a qualified nurse or health care provider.
3. Explain procedures as much as possible to the woman during this emergent situation.
4. Administer oxygen by face mask at 8 to 10 L/min.
5. Relieve pressure from the presenting part of the fetus off the umbilical cord by manually pushing the presenting part upward with a gloved hand. Pressure must be relieved until the fetus is delivered via cesarean or vaginally.
6. Provide constant support to the woman and her support persons.
7. Encourage the woman to talk about her feelings regarding herself and the baby after delivery.
B. Tocolytic Therapy
If conservative therapy is not successful, tocolytic therapy is instituted. These drugs should be used only when the potential benefit to the fetus outweighs the potential risk
1. Betamimetic agents such as ritodrine (Yutopar) and terbutaline (Bricanyl)
a. These drugs stimulate the β2 receptors, which causes uterine relaxation.
b. Ritodrine is administered IV or orally; terbutaline may be administered IV, subcutaneously, or orally.
c. Frequent monitoring is necessary to observe for side effects of increased pulse, shortness of breath, chest pain, decreased blood pressure, hypervolemia, decreased potassium concentration, hyperglycemia, and hyperinsulinemia.
d. Before beginning administration of these medications the following laboratory tests should be done and a baseline ECG should be obtained: CBC with differential, electrolytes, glucose, BUN, creatinine, prothrombin time and partial thromboplastin time.
2. MgSO4
a. MgS04 interferes with smooth muscle contractility. The exact action is not clear.
b. Administration is IV on an infusion pump.
c. During administration the woman is monitored for pulmonary edema, loss of deep tendon reflexes, decreased respirations, hypotension.
d. Serum magnesium levels are monitored.
e. Calcium gluconate is the antidote for MgS04 and should be at the bedside.
3. Indomethacin (Indocin)
a. Indomethacin is a prostaglandin inhibitor that inhibits contractions.
b. Administration is oral or rectal.
c. It is usually well tolerated by the woman.
4. Nifedipine (Procardia)
a. Nifedipine is a calcium channel blocker that relaxes smooth muscle.
b. Administration is oral.
c. Side effects include headache, nausea, and flushing from vasodilatation.