Page 674 - Saunders Comprehensive Review For NCLEX-RN

5. Avoid excessive weight gain.
6. During labor, prepare to do the following:
a. Monitor vital signs frequently.
b. Place the client on a cardiac monitor
and on an external fetal monitor.
c. Maintain bed rest, with the client lying
on her side with her head and
shoulders elevated.
d. Administer oxygen as prescribed.
e. Manage pain early in labor. Cardiology
clearance may be required for
epidural, spinal, or general anesthetic
agents.
f. Use controlled pushing efforts to
decrease cardiac stress.

Excessive weight gain places stress on the

heart. In addition, obesity places the client at
increased risk for complications during pregnancy.
IV. Chorioamnionitis
A. Description
1. Bacterial infection of the amniotic cavity; can result
from premature or prolonged rupture of the
membranes, vaginitis, amniocentesis, or intrauterine
procedures
2. May result in the development of postpartum
endometritis and neonatal sepsis
B. Assessment
1. Uterine tenderness and contractions
2. Elevated temperature
3. Maternal or fetal tachycardia
4. Foul odor to amniotic fluid
5. Leukocytosis
C. Interventions
1. Monitor maternal vital signs and fetal heart rate.
2. Monitor for uterine tenderness, contractions, and fetal
activity.
3. Monitor results of blood cultures.
4. Prepare for amniocentesis to obtain amniotic fluid for
Gram stain and leukocyte count and other testing as
prescribed.
5. Administer antibiotics as prescribed after cultures are
obtained.
6. Administer oxytocic medications as prescribed to
increase uterine tone.
7. Prepare to obtain neonatal cultures after birth.

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