Liceo de Cagayan University

College of Nursing

Midterm Module 3 Lecture Assignment

I. Title: Intrapartum Complications

II. Overview: In this session, learners will learn information about what happens when
complications of labor occur.
III. Learning Outcomes: At the end of the session the learner will be able to:
● Utilize critical thinking to analyze ways to maintain family-centered nursing care
when deviations from the normal in labor or birth occur.
● Assess a woman in labor and during birth for deviations from the normal labor
process.
● Integrate the knowledge of deviations of normal in labor and birth with nursing
process to achieve quality maternal and child health nursing care
IV. Content:
● Complications during Labor and Delivery
V. Learning Activities:
● Synchronous and Asynchronous Google Meet. Power point presentation
VI. Learning Materials/Resources:
● Maternal and Child Health Nursing by Adele Pillitteri
VII. Self- Check Test:
1. What is Precipitate Labor?
Precipitous labor is extremely rapid labor and delivery. It is defined as expulsion of
the fetus within less than 3 h of commencement of regular contractions

2. List nursing measures that can be used when a woman has precipitate labor.
a. Promoting fetal oxygenation
Adjunctive measures to promote fetal oxygenation include intravenous fluid
bolus, reduce uterine contraction frequency. Initiate scalp stimulation to provoke
fetal heart rate acceleration, which is a sign that the fetus is not acidotic
b. Promoting maternal comfort
Comfort measures that provide natural pain relief can be very effective during
labor and childbirth.

3. Situation: The nurse notes that a small amount of fluid with a strong odor is
draining from patient’s vagina. Using a speculum examination to obtain fluid, the
pH test turns blue-black on contact with the fluid, and a fern test is positive.
Maternal vital signs are as follows: temperature, 37.2° C; pulse, 86 bpm;
respirations, 22 breaths/min; and blood pressure, 132/80 mm Hg. The fetal heart
rate is 162 to 170 bpm. The patient occasionally has a contraction lasting 20 to
30 seconds.

a. Which data from these assessments are most relevant?

Fluid draining from the vagina; positive pH (7.5) and fern tests; fluid with a strong odor;
fetal tachycardia; occasional contraction

b. What is the main judgment that you would make from these data?
The vaginal fluid drainage and the positive pH and fern test results suggest that Ann's
membranes have ruptured. Infection is suggested by the strong fluid odor and fetal
tachycardia. Contractions suggest possible preterm labor

c. Would you perform a vaginal examination at this point? Why or why not?
A vaginal examination is not advised at this time because the vaginal discharge is
typical of amniotic fluid (meaning that the membranes are truly ruptured); there already
appears to be an infection, Ann's gestation is preterm, and she is already having
 Liceo de Cagayan University
College of Nursing

contractions. Little information is likely to be gained from the examination, and an

examination might introduce more microorganisms into the uterus and may increase
contractions. The physician may perform a speculum or vaginal examination or
specifically order one

4. What are the 2 classifications of Rupture of the uterus

a. uterine intervention or predisposing anomaly present before the current
pregnancy
b. uterine injury or abnormality during a current gestation.

5. What are the Risks Factors and signs of Rupture of the Uterus?
● excessive vaginal bleeding.
● sudden pain between contractions.
● contractions that become slower or less intense.
● abnormal abdominal pain or soreness.
● recession of the baby's head into the birth canal.
● bulging under the pubic bone.
● sudden pain at the site of a previous uterine scar.

6. Identify the Management for Ruptures Uterus.

Diagnosis of uterine rupture is confirmed by laparotomy. Treatment of uterine rupture is
immediate laparotomy with cesarean delivery and, if necessary, hysterectomy.

VIII. Assessment:
● 20 Items Quiz

Prepared by: Maria Estela L. Villegas MN. RN