Multiple gestation, intrauteine grewth restrktion,gestational diabetes, preeclampsla,age extremes, stress, substarce abuse,anemia, trauma, STts, infection, history of preterm labor

Definition

Nursing Diagnoses

Risk for fetal impained gas exchange r/t possible ccrd compressicn,ineffective tissue perfusion r/t side effects of Magnesium Sulfate,fiuid volume imbalance r/t administration of Magnesium Sulfate,constipation r/t decreased mobillity and medication,pain r/t preterm labor cortracticns, fear r/t unkncwn cutcome of birtth, deficiertknowledge /t lack of information of problems associated with muitiple gestations,

Assessment

Assessment completed 9-12-D7. Patient was awake and alert, refiexes were p+2-Temperature - 36-4 c, pulse - 79, blocd pressure - 12/69, respirations - 16patient was negative for edema and homans sign, SCD 's were on. Lungs were cleae to auscultation billaterally, Respirations were even and unlabored.Abdomen was soft and bowel sounds were nonmoactive, urine, Vision was Clear.Mernbranes were intavt and negative for vaginal bleeding.Fetal heart rates were 'a'-135 and 'b'-135 bpm with good variabillity and a-ccerations,Contractions were two per hour at 40 seonds in length with mildd irtensity (nose)-

Interventions

Assessments

monitors

Lob Tests.

Medicaltions

Assess

Side effects,therapeutic effects,vital signs,contractions

Goals

-patient will have -c2 contractions per hour with a lenhth <45 seconds aftre 24 hours.-patient panin level will remain under5/10 until delivery,patient will remain free from Dvt's until discharge.patient will eat>50% of meals until discharge.-patient will contirue to have 1 BMper day untill discharge

Outcomes

-patient' will remain inuteroas long as possible,-patient's pain will be manageable,-patient will maintain good bloodcircullation--patient will malrtain adequatenutrition, -patient will mairtain adequate GI motillty,

Matemal

Fetal

Blood pressure: 123/69pulse:79Tocodynarometer:x2 per hour40 seconds in length

Fetal heart ratenormal: 110 -160 bpmTwin a & B:135 bpm

Speculation examBlood testsUrinalysisUitrasoundCervical lengthFetal fibronectin (FN)

Goals

Diagnosed

Symptoms

Abdomanal pain, back pain, diarrheapeivic pain, cramps,vaginal bieeding, vaginal discharge,pelvic pressure,urinary frequency,

Bishop's score,Cervical length,Fetal fibronectin (fFN) levels,Electroric monitoring

Labor that begins beforecompletion of 37 weeks butafter 20 weeks from yhe last menstrual period

Risks for