Toaz - Info Group 4 Cephalopelvic Disproportion 1stcheckingdocx PR

Republic of the PhilippinesNUEVA ECIJA UNIVERSITY OF
Cabanatuan City, Nueva Ecija, Philippines

SCIENCE AND TECHNOLOGY
COLLEGE OF NURSING
CEPHALOPELVIC DISPROPORTION
_________________________
A Case Analysis
Presented to the Faculty of the
College of Nursing
In Partial Fulfillment of the
Requirements for the Subject
RELATED LEARNING EXPERIENCE
NCM ___
Submitted by:
Students Name (Family, Given, MI)
Submitted to:
Archito Lajom de La Cruz, MAN, RN
Clinical Instructor
November 2020
Contact No. (044) 463-0825

Transforming Communities through Science and Technology Email: neustmain@yahoo.com
www.neust.edu.ph
COLLEGE OF NURSING
CHAPTER I
The Problem and Its Setting

Overview
(State here what are the topics included in this chapter)
GENERAL OBJECTIVE
This study aims to provide knowledge about what

Cephalopelvic Disproportion or (CPD) means, to also know the
causes and complications of it. As nursing students, we
should be familiarized with the signs and symptoms of the
said condition, and what are the corresponding nursing
interventions for Cephalopelvic Disproportion (CPD).
SPECIFIC OBJECTIVES
At the end of this analysis, we will be able to do the
following:
 Understand and discuss what is Cephalopelvic

Disproportion means.
 Enumerate the complications of CPD.
 Discuss the management for Cephalopelvic
Disproportion.
 Discuss the Anatomy and Pathophysiology of CPD.
 Enumerate the signs and symptoms of CPD.
 Identify and understand the
different types of medical treatment necessary for
the CPD clients.
 Formulate an appropriate Nursing Care Plan and
Drug Study
Contact No. (044) 463-0825

www.neust.edu.ph
COLLEGE OF NURSING
INTRODUCTION
Cephalopelvic disproportion (CPD) is a complication in

pregnancy in which there is a size imbalance between the
pelvis of the mother and the head of the fetus. The head of
the infant is proportionally very big or perhaps the pelvis
of the mother was very small for the baby to pass through
the pelvic opening easily. This can make it risky or
difficult to vaginally deliver. Physicians can immediately
move on to a C-section once an attempted vaginal delivery is
ineffective. Prolonged/obstructed labor from Cephalopelvic
Disproportion will lead to birth disorders such as hypoxic-
ischemic encephalopathy (HIE) and cerebral palsy (CP) if
they are unable to do the cesarean section. Caesarean
Delivery, also known as Caesarean Section, is a major
abdominal surgery involving 2 incisions (cuts), One is an
incision through the abdominal wall (LAPAROTOMY) and the
second is an incision involving the uterus (HYSTERETOMY) to
deliver the baby (Louis, 2018).
Fetal macrosomia is a medical term for when the fetus

is overly large. It is described as over 8lbs 13 oz of
macrosomia. Macrosomia affects around 10 percent of
pregnancies and 50 percent of pregnancies with gestational
diabetes. An infant grows too large to be vaginally born.
For a variety of factors, babies may be huge, such as
physically big or obese parents (hereditary variables),
mothers with diabetes or gestational diabetes, having a male
vs. a female infant, post-term pregnancy (baby still not
born past his/her due date).
Contact No. (044) 463-0825

www.neust.edu.ph
COLLEGE OF NURSING
Tiny or abnormally formed pelvises are also possible
for mothers. This happens because of a previous injury or
genetic factors to the pelvis. Adolescents and women who are
shorter are much more likely to encounter such problem.
Giving birth can also cause an injury or malformation of the
pelvis. The pelvis can be deformed, have bony growths, or
have an out-of-place bone. Polyhydramnios (excess amniotic
fluid) and multiparity (previously birthed, either
vaginally) are other risk factors.
In order to predict or verify Cephalopelvic

Disproportion, obstetricians may use radiologic pelvimetry,
a type of imaging technology that determines the
measurements of the mother's pelvis. To measure the size of
the head of the fetus, ultrasounds may be used. Studies
found, however a weak link between the use of imaging
technology and the effects of labor. That is because the
bones in the head of the fetus are supposed to change form
in order for the baby to pass through the birth canal. Most
petite mothers carrying babies with large-looking heads may
still be able to do vaginal delivery successfully. In
addition, equipment for imaging may not be as reliable as
obstetricians would like. They can only guess the size of
the infant, not exactly weigh it.
Even when a mother in experienced Cephalopelvic

Disproportion in one pregnancy, it does not mean that she
will experience it again in her next pregnancies. According
to a study, about 65 percent of women was diagnosed with
Cephalopelvic Disproportion was able to give birth to
another baby vaginally. Mothers may opt to have a cesarean
section or try a vaginal delivery in this case.(reference)
Contact No. (044) 463-0825
www.neust.edu.ph
COLLEGE OF NURSING
PATIENT’S PROFILE:
Name: Celine Dior
Age: 19 years old
Sex: Female
Weight: 7o kilograms
Height: 5’2 feet tall
Nationality: Filipino
Religion: Roman Catholic
Date Admission: August 24, 2020
Final Diagnosis: Caesarian Section II: Cephalopelvic

Disproportion.
OB-Gyne Physician: Dra. Lirio
Contact No. (044) 463-0825

www.neust.edu.ph
COLLEGE OF NURSING
MATERNAL HISTORY:
OB SCORE: G2P1
Cesarean delivery on first child. First Pregnancy in a

baby boy born at 40 weeks gestation. (now 3 years old alive
and well. No history of miscarriage.
1.Antepartal / Prenatal Preparations.
Celine Dior managed to exercise less than 30 minutes

per day especially during her 3rd trimester (walking around
her neighborhood every afternoon) client and family prepared
for financial expenses didn't take any drugs or any vitamin
supplement.
2.Significant Trimester Changes
FIRST TRIMESTER
 Striae Gravidarum (stretchmarks)

 Linea nigra
 Morning sickness three times a day for three months
 Her breast where sensitive and tender
 Often urinate
 Extreme fatigue and being emotional
 Rarely sleeps in the afternoon and keeps on waking up
every 2 hours in the evening
SECOND TRIMESTER
 Daily cravings (pineapple juice and ice cream)

 Saw obvious changes in her abdomen as a sign of further
uterine enlargement
 Back pain due to sitting and standing
Contact No. (044) 463-0825

www.neust.edu.ph
COLLEGE OF NURSING
 Feel the baby move though it is still not that evident
to her
 Sleeping schedule went back to normal
THIRD TRIMESTER
 Sleeping schedule changed again (because of Shortness

of Breath)
 Quickening at least 10 times a day
Contact No. (044) 463-0825

www.neust.edu.ph
COLLEGE OF NURSING
ADMITTING HISTORY:
Celine is a 19 year old, admitted to the ward for
cesarean section II due to Cephalopelvic Disproportion.
Membranes are still intact. The fetal baseline is 150,
external variability is average, and there are no
decelerations. Mild contractions are noted. The cervix is 2-
3cm and 50% effaced.
PHYSICAL ASSESSMENT
BODY PARTS NORMAL FINDINGS ACTUAL FINDINGS
Skull Generally round, with Round and no

prominences in the tenderness noted
frontal and occipital upon palpation
area. No tenderness noted
upon palpation
Scalp Normally lighter than Moist scalp and no
skin color, can be moist infestation noted
or oily, no infestation
noted
Hair Hair evenly distributed, Hair is black and is
can be black, brown or evenly distributed
burgundy, maybe thick or
thin
Face Face is symmetrical, no Face is symmetrical,
involuntary muscleno involuntary
movement, can move facial muscle movements
muscles at will, intact noted, cranial
cranial nerve 5 and 7 nerves 5 and 7 are
intact as well
Eyes Extraocular motions full, Equal pupil size,
gross visual fields full round, and reactive
to confrontation, to light.
conjunctiva clear, PERRLA
Ears Hearing bilaterally Hearing essentially
normal, tympanic membrane normal upon
landmarks well visualized assessment
Contact No. (044) 463-0825

www.neust.edu.ph
COLLEGE OF NURSING
Nose and No discharge, no Symmetrical, no
Paranasal obstruction, septum not discharges noted
Sinuses deviated
Mouth Complete set of upper and Dentures complete
lower dentures, Uvula and with normal gag
moves up in the middle, reflex
normal gag reflex
Neck Jugular venous pressure No palpable lumps
7cm, thyroid not noted
palpable, no masses
Chest No masses, Lungs; no No masses or lumps,
dullness to percussion, no dullness upon
Thorax diaphragm moves well with percussion
respiration, No rhonchi,
wheezes or rubs.
Abdomen Soft, flat, bowel sounds Abdomen is round and
present, no bruits. Non fundal height at
tender upon palpation 36cm
Extremities Skin warm and smooth, no Skin warm and smooth
clubbing nor cyanosis, with no palpable
non pitting and tender masses
upon palpation
Skin Skin color is uniform Skin color is
over the body, no signs uniform throughout
of pallor, erythema, the body
cyanosis or jaundice
Genital Area Skin over mons pubis is Proportional hair
clear with normal hair distribution, no
distribution. Labia abnormalities noted.
minora and majora Cervix at 2-3cm and
symmetrical, with 50 percent effaced
somewhat wrinkled,
unbroken, slightly
pigmented skin surface,
no ecchymosis,
excoriation, nodules,
swelling, rash, or
lesion.
Discussion of the table presented… in narrative format
Contact No. (044) 463-0825

www.neust.edu.ph
COLLEGE OF NURSING
CHAPTER II
CASE DISCUSSION
Overview
(topics included in chapter 2)
DEFINITION OF CASE
Cephalo-Pelvic Disproportion arises whenever the pelvic

canal cannot accommodate the fetal head, or is too narrow to
allow the fetal head to pass through for a spontaneous
delivery. This complication happens when there’s a mismatch
between the mother’s pelvis and fetus head.
Some factors that may affect this are; the mother’s diet,
An unbalanced diet can be a risk factor for pregnant women
to undergo cephalopelvic disproportion. This may be due to
the mothers consumption of food is exceeding the maximum
amount of daily required intake then the fetal growth will
be affected as well. Sedentary lifestyle can also be a risk
factor since sedentary behavior during pregnancy may lead to
unstable or increased blood pressure and thus triglyceride
process may affect the intra-uterine environment and fetal
development causing increase in fetal birth size. Maternal
obesity is another risk factor because excessive weight gain
during pregnancy is typically defined as gaining more than
1.5 pounds per week, and exceeding this rate may impact the
pregnancy and possibly cause CPD. Gestational diabetes,
macrosomia is a common accompaniment of CPD if not diagnosed
correctly, this causes macromegali to the fetus. Other
factors include age, fetal position, increased fetal weight,
polyhydramnios or abnormal increase in the volume of
Contact No. (044) 463-0825

www.neust.edu.ph
COLLEGE OF NURSING
amniotic fluid, multiparity, and previous cesarian delivery.
(reference)
ANATOMY AND PHYSIOLOGY
Figure No.__: ___________

Women have the responsibility of bringing forth life
into the world, hence the creation and the function of the
female reproductive system. This system performs a miracle
from the conception of life until the birth of the growing
life within. We all know that reproductive system in females
is responsible for producing gametes (called eggs or ova),
certain sex hormones, and maintaining fertilized eggs as
they develop into a mature fetus and become ready for
delivery. So I will provide analysis and brief knowledge
about the anatomy and physiology of this system.
(References)
Vagina - is a muscular cannal approximately 10 cm long that

serves as the entrance to reproductive tract. It also
Contact No. (044) 463-0825

www.neust.edu.ph
COLLEGE OF NURSING
functions as an exit from the uterus during menstrual
periods and during childbirth.
Ovaries - these are the female gonads which are about 2-3 cm
in length. It is attached to the uterus via the ovarian
ligament, the ovaries produces oocytes.
Uterus - it is the largest female reproductive organ, it

houses the
developing fetus, produces vaginal and uterine secretions,

and passess the anatomically male sperm through the
fallopian tubes and the ovaries.
Figure #__: ______
Contact No. (044) 463-0825

www.neust.edu.ph
COLLEGE OF NURSING
Fallopian tube - these are narrow tubes that are attached to
the upper part of the uterus and serves as a pathway for the
egg cells to travel from the ovaries to uterus
Cervix - opening of the uterus
The External Structure comprises of:
Labia Majora - or literally translates to large lips, this

encloses and protects the other external reproductive organs
Labia Minora - or small lips, lie just inside the labia

majora and it surrounds the opening of the vagina.
Bartholin’s glands - which are located beside the vaginal

opening and produces mucous secretion
Clitoris - this is a small, sensitive protrusion that is

comparable to the male penis. Like a penis, the clitoris is
very sensitive to stimulation and can become erect.
(reference)
SIGNS AND SYMPTOMS
Contact No. (044) 463-0825

www.neust.edu.ph
COLLEGE OF NURSING
Table of comparison book based and client based
BOOK BASED CLIENT BASED
Table #__: ______
 Prolonged labor
Friedman describes prolonged labor or arrested

labor as less than 1.2 cm/hour of cervical dilation for
the first pregnancy of a woman and less than 1.5
cm/hour for a woman who has already given birth. It is
due to the fetus's difficulty in falling to the pelvic
region.
 Dehydration and exhaustion of the mother
There will be an inadequate amount of fluid and

energy for the patient due to prolonged work. This is a
consequence of insufficient labor development due to
inadequate uterine intervention in the first stage and
poor maternal effort during the second stage of labor.
 Pain around the back, sides, and thighs
The discomfort that can be perceived as intense

cramping in the belly, groin and back, as well as an
achy feeling, is due to the pain caused by contractions
of the uterus muscles and pressure on the cervix during
childbirth. Some women often feel discomfort in their
thighs or arms.
 Increased heart rate of the mother
Contact No. (044) 463-0825

www.neust.edu.ph
COLLEGE OF NURSING
Rising sedentary behavior prevalence and absence
of aerobic fitness can decrease reserve heart rate
during labor. Therefore, the lack of aerobic fitness
during childbirth will restrict pushing efforts and
represents increased cardiovascular strain and risk.
 Shoulder Dystocia
When the head of the fetus has been successfully

delivered, Shoulder Dystocia can occur but get trapped
because the fetus' shoulder cannot move through. It may
be due to being trapped in the pelvis of the mother
because it is too small for the size of the fetus or
because the fetus is too large to move through.
(reference)
Contact No. (044) 463-0825

www.neust.edu.ph
COLLEGE OF NURSING
CAUSES
Possible causes of cephalopelvic disproportion (CPD)
include:
 Large baby due to:
 Hereditary factors
 Diabetes mellitus
 Post maturity (still pregnant after the due date

has passed)
 Multiparity (not the first pregnancy)
 Abnormal fetal positions
 Small pelvis
 Abnormally shaped pelvis
 (reference)
TREATMENTS
Treatment for CPD varies based on severity and when it

is diagnosed. If it is severe and diagnosed early, a planned
C-section is indicated. In other cases, CPD may be treated
with a symphysiotomy (the surgical division of pubic
cartilage) or an emergency C-section after a trial of labor.
When CPD is present, continued attempts to deliver the baby
vaginally can cause undue trauma and permanent injury to the
baby. (reference)
Contact No. (044) 463-0825

www.neust.edu.ph
COLLEGE OF NURSING
PREVENTION
According to an article wrote by Donna Murray, RN, BSN that

is medically reviewed by Anita Sadaty, MD, It is difficult
to prevent since cephalopelvic disproportion is not usually
diagnosed until there is a problem during labor. However,
during your pregnancy, your doctor will examine you and
monitor your infant.
(reference)
Contact No. (044) 463-0825

www.neust.edu.ph
COLLEGE OF NURSING
PATHOPHYSIOLOGY
Figure No.__: _____
Discussions
Precipitating Factors:
 Diet
An unbalanced diet can be a risk factor for pregnant

women to undergo cephalopelvic disproportion. This may be
due to the mother’s consumption of food is exceeding the
Contact No. (044) 463-0825
www.neust.edu.ph
COLLEGE OF NURSING
maximum amount of daily required intake then the fetal
growth will be affected as well.
 Sedentary Lifestyle
Sedentary behavior during pregnancy may lead to

unstable or increased blood pressure and thus triglyceride
process may affect the intra-uterine environment and fetal
development causing increase in fetal birth size. Also,
sedentary behaviors during pregnancy have been associated
with increased risk for gestational diabetes mellitus.
 Maternal Obesity
Obesity during pregnancy or also known as maternal

obesity is defined as a body mass index of greater than 30.
Excessive weight gain during pregnancy is typically defined
as gaining more than 1.5 pounds per week, and exceeding this
rate may impact the pregnancy and possibly cause CPD.
 Gestational Diabetes
Gestational diabetes mellitus, macrosomia is a common

accompaniment of CPD if not diagnosed correctly. Specially
in women with uncontrolled glycemia. Low insulin to possibly
non-insulin mother would cause the excessive glucose to pass
by filtration or insulin binding properties to lower glucose
level and enter the fetus causing macromegali, since unused
glucose would be stored in the body.
Predisposing Factors:
 Age
Contact No. (044) 463-0825

www.neust.edu.ph
COLLEGE OF NURSING
The maternal age of the woman refers to how old the woman
is when she gives birth. According to Lisonkova, Sarka, et
al. (2017), “advanced maternal age” – which, according to
many experts, is as young as 35 – is a risk factor for a
variety of issues that can occur during pregnancy, labor,
and delivery.
 Post-mature baby
In cases of post-term pregnancy, the fetus may be too

large because it became over-developed in the womb, making
delivery difficult and increasing the risk for birth trauma,
brain bleeds, hypoxic-ischemic encephalopathy (HIE),
cerebral palsy, seizures, and other forms of brain damage.
 Fetal Position
Before delivery, it is critical that the fetus is in this

standard vertex presentation and within the normal range for
weight and size. This helps ensure the safety of both baby
and mother during labor. Any position other than vertex
position is abnormal and can make vaginal delivery much more
difficult or sometimes impossible. (Moldenhauer, 2018).
 Increased Fetal Weight
Risk factors for fetal macrosomia include mothers who are

maternal obesity or overweight (more than 8 pounds, 13
ounces (4,000 grams), regardless of his or her gestational
age.
 Polyhydramnios
Contact No. (044) 463-0825

www.neust.edu.ph
COLLEGE OF NURSING
Polyhydramnios is also called as hydramnios or amniotic
fluid disorder, is a pregnancy complication in which there
is an abnormal increase in the volume of amniotic fluid.
According to Hamza (2013), symptoms and complications of

polyhydramnios include maternal breathing difficulties,
preterm labor, premature rupture of membranes (PROM),
unusual fetal presentation, umbilical cord prolapse, and
postpartum hemorrhage.
 Previous Caesarean delivery
Women who have had a previous caesarean delivery are at

increased risk of unexplained stillbirth in the second
pregnancy. A mother may have the risk of having a large
fetus.
 Multiparity
Multiparity which refers to a mother that has previously

been pregnant. Woman who are multiparas, tend to be more
likely to be of old age which might be the reasons for
increased morbidity and mortality. It can have many medical
and obstetrical complications because of its risk factors in
labor and delivery.
(reference)
Contact No. (044) 463-0825

www.neust.edu.ph
COLLEGE OF NURSING
CHAPTER III
LABORATORY RESULTS
Overview
Book based and client based
COMPLETE BLOOD COUNT
Contact No. (044) 463-0825

www.neust.edu.ph
COLLEGE OF NURSING
NURSING MANAGEMENT
 Assist with activities and provide/monitor client’s use

of assistive devices such as a wheelchair
 Instructed to put a pillow on the abdomen when moving.
 Provide diversionary activities. Initiate ankle

pumping, active lower extremity ROM, and walking
 Inspect skin on daily basis and observe for changes and

any unusual findings
 Keep the area clean, carefully dress wound, support

incision, and prevent infection
 Encourage client to demonstrate good skin hygiene,

e.g., washing thoroughly and patting dry carefully
after teaching.
CLINICAL MANAGEMENT
 Give appropriate IV fluids
 Give medications via oral and IV
 Clear liquid diet instructed before the patient undergo

cesarean section
 Short term General Liquid Diet instructed after post op

surgery.
 Soft Diet is also instructed since she is not ready for

foods of normal consistency or with too many spices
after post op surgery.
Contact No. (044) 463-0825

www.neust.edu.ph
COLLEGE OF NURSING
 DAT instructed after her surgery.
 Assess the client’s medication response
DIAGNOSTIC PROCEDURES
Listed below are several methods employed by physicians to

try and assess the size of the pelvis and baby, which can
help to diagnose CPD:
 Pelvimetry by MRI: This is used to assess the

dimensions of the pelvis, determine the baby’s
position, and examine the soft tissues of the mother
and baby.
 Clinical pelvimetry: This is a process used to assess
the size of the birth canal using the hands and/or with
a pelvimeter.
 Ultrasound: The baby’s head and body size are measured
during a routine ultrasound examination. Measurements
are compared against standardized growth charts to
determine the relative risk of CPD by the time of
delivery.
 X-ray or CT pelvimetry: This is a radiographic
examination used to determine the dimensions of the
mother’s pelvis and the diameter of the baby’s head.
The value of x-ray pelvimetry needs to be weighed
against the risk of radiation exposure.
Contact No. (044) 463-0825

www.neust.edu.ph
COLLEGE OF NURSING
CHAPTER IV
NURSING CARE PLAN

ASSESSMENT DIAGNOSIS
OUTCOME PLANNING INTERVENTION EVALUATION
IDENTIFICATION
Subjective: Impaired At the end of Short Term: Independent: After nursing
“May hiwa Skin nursing After 8 hours  Established interventions;
ako sa may Integrity intervention of nursing rapport. the patient
tiyan dahil related to the client interventions, (Rationale : was able to
would be able
na CS ako” alteration the patient To have a good display a
to maintain a
as in skin normal skin
will be able nurse-client timely healing
verbalized integrity integrity free to participate relationship) of skin
by the secondary of skin in prevention  Inspect skin lesions/
patient. to lesions/wounds measures and on daily basis wounds without
caesarean treatment and observe complication.
Objective: section as program for changes The goal was
Incision manifested and unusual met.
site on by_____. Long Term: findings
abdomen After 3 days (Rationale: To
of nursing determine
Destruction interventions, unusual ties
of skin the patient and report it
layers will be able to physician
to display for prompt
Disruption timely healing treatment.)
of tissue of skin
 Keep the area
layers. lesions/
clean,
wounds without
carefully
complication.
dress wound,
support
Contact No. (044) 463-0825

www.neust.edu.ph
COLLEGE OF NURSING
incision, and
prevent
infection
(Rationale:
This will
assist body’s
natural
process of
repair.)
 Encourage
client to
demonstrate
good skin
hygiene, e.g.,
washing
thoroughly and
patting dry
carefully
after
teaching.
(Rationale:
Maintaining
clean, dry
skin provides
a barrier to
infection.
Patting skin
dry instead of
rubbing
reduces risk
Contact No. (044) 463-0825

www.neust.edu.ph
COLLEGE OF NURSING
of dermal
trauma to
fragile skin)
Dependent:
Administer
medication as per
doctor’s order.
(Rationale: To
prevent post-
operative wound
complication)
Collaborative:
Provide optimum
nutrition such as
increased protein
intake.
(Rationale: To
provide a
positive nitrogen
balance to aid in
healing.)
Contact No. (044) 463-0825

www.neust.edu.ph
COLLEGE OF NURSING
CHAPTER V
DRUG STUDY (CEFUROXIME)
DRUG NAME MECHANISM OF INDICATIONS CONTRAINDICATIO ADVERSE NURSING
ACTION NS REACTIONS RESPONSIBILITIES
Generic name Bind to Treatment of  Use cautiously Local Before
bacterial the following in patients Administration
Cefuroxime cell wall infections >Pain at IM
with renal
membrane, caused by impairment, site, >Ensure ten rights
Brand name
causing cell susceptible patients with phlebitis at of drug
Zinacef death. organisms: hepatic IV site administration
Respiratory dysfunction, (Rationale: to
Classificati tract CNS
on poor always make sure an
infections, nutritional >Seizures
Anti- Skin state, or (high dosage) appropriate
and skin cancer may be integration of
infectives
structure Hematologic giving the drug)
at risk for
Dosage infections, bleeding; >Assess for
>Agranulocyto
Bone and History of GI infection
PO (Adults sis,
joint disease, (Rationale: to
and Children bleeding,
infections, especially
>12 yr):
Urinary tract colitis eosinophilia, identify the
Pharyngitis/ haemolytic appearance of wound,
infections  Contraindicate
tonsillitis, anemia, stool, urine and
Meningitis, d in
maxillary WBC)
gynecologic hypersensitivi neutropenia,
sinusitis,
infections, ty to thrombocytope
uncomplicate >Before initiating
and Lyme cephalosporins nia
d therapy, obtain a
disease. , serious
UTIs—250 mg
sensitivity to GI history to determine
q 12 hr.
penicillins >Pseudomembra
Bronchitis, previous use of and
neous
Contact No. (044) 463-0825

www.neust.edu.ph
COLLEGE OF NURSING
uncomplicate colitis, reactions to
d diarrhea, penicillins or
skin/skin cramps, cephalosporins.
structure nausea, (Rationale: Persons
infections— vomiting
250–500 mg with a negative
q12 Integumentary history of
hr. penicillin
Gonorrhea—1 >Rashes, sensitivity may
g (single urticaria still have an
dose). allergic response.)
Lyme disease
>Obtain specimens
—
500 mg q 12 for culture and
hr for 20 sensitivity before
days. initiating therapy.
PO (Children >Administer the drug
3 mo–12 yr): around the clock
Otitis with full or empty
media, acute
stomach (Rationale:
bacterial
maxillary administration with
sinusitis, food may minimize
impetigo—15 the GI irritation)
mg/kg q 12 >Lab Test
hr as oral Considerations: May
suspension cause positive
(not to results for Coombs’
exceed 1 test in patients
g/day) or receiving high
250mg q 12 doses or in neonates
hr as whose mothers were
tablets. given cephalosporins
Contact No. (044) 463-0825

www.neust.edu.ph
COLLEGE OF NURSING
Pharyngitis/ before delivery.
tonsillitis— During
10 mg/kg q administration
12 hr as
oral >Observe patient for
suspension signs and symptoms
(not to of anaphylaxis
exceed 500 (rash, pruritus,
mg/day). laryngeal edema,
wheezing).
(Rationale:
Discontinue the drug
immediately if these
symptoms occur. Keep
epinephrine, an
antihistamine, and
resuscitation
equipment close by
in the event of an
anaphylactic
reaction.)
>Monitor bowel
function. Diarrhea,
abdominal cramping,
fever, and bloody
stools should be
reported
to health care
professional
promptly as a sign
Contact No. (044) 463-0825

www.neust.edu.ph
COLLEGE OF NURSING
of pseudomembranous
colitis.
After administration
>Emphasize the
importance of
continuing to take
medication as
directed at the same
time each day and to
finish the
medication
completely even if
feeling better.
>Advise the patient
to report any signs
of super-infection
(furry overgrowth on
the tongue, vaginal
itching or
discharge, loose or
foul-smelling
stools) and allergy.
>Instruct patient to
notify health care
professional if
fever and diarrhea
develop, especially
if stool contains
blood, pus, or
mucus. Advise
patient not to treat
Contact No. (044) 463-0825

www.neust.edu.ph
COLLEGE OF NURSING
diarrhea without
consulting health
care professional.
Contact No. (044) 463-0825

www.neust.edu.ph
CHAPTER IV
EVALUATION:
Cephalo-pelvic disproportion is a condition in which there
is a mismatch between the fetus size and the mother’s pelvis
which is a complication in pregnancy that may result from
different predisposing factors. There are several ways on
diagnosing this condition and upon diagnosis a caesarian section
is required to deliver the fetus.
CONCLUSIONS:
It is important that aside from examining the fetal size and the
mother’s pelvic condition in assessing for the possibility of CPD, it
is crucial to always include the patients diet, lifestyle, and other
illness that may contribute to failure of vaginal delivery such as
gestational diabetes and maternal obesity.
RECOMMENDATIONS:
It is necessary that the medical professionals involved in

the examining of the condition of the mother and the fetus is to
ensure that they could identify the cause or the factor that is
preventing the fetus from making its way through the birth canal,
but more importantly to diagnose what exactly the problem is.
METHODS – SAMPLE ONLY
Medication:
Antibiotics usually are the first line medication for urinary tract
infections.
Environment/Exercise:
The client was advised to walk in the afternoon too since she walks
every morning, she cannot do any chores that’s why walking as her
exercise is good even 10 minutes per day, having an exercise per day
can reduce fatigue and can manage stress and anxiety.
Treatment:
 Drink plenty of water. Water helps to dilute your urine and

flush out bacteria.
 Avoid drinks that may irritate your bladder. Avoid coffee,

alcohol, and soft drinks containing citrus juices or caffeine
Contact No. (044) 463-0825

www.neust.edu.ph
until your infection has cleared. They can irritate your
bladder and tend to aggravate your frequent or urgent need to
urinate.
 Use a heating pad. Apply a warm, but not hot, heating pad to
your abdomen to minimize bladder pressure or discomfort.
Health Teaching:
 Educate the client to talk about her pain with the family
members in assessing severity, frequency, and characteristic
of pain to help her determine level of it.
 The client is encouraged to have deep breathing exercise to

help alleviate stress and anxiousness caused by the pain.
 Personal Hygiene is important to prevent infection.
 Advice to take medications on time and with the right dose.
 Instruct the patient to eat nutritious food such as vegetables

and fruits.
OPD (Follow up Checkup):
 Instruct the patient to comply with the prescribed medication.
 Encourage patient to visit physician one to two weeks after

discharge from the hospital
 Instruct the patient to visit physician immediately if any

unusualities arise.
Diet:
The client is advised on healthy diet of high antioxidant foods. These

foods include cranberries, blueberries, oranges, dark chocolate,
unsweetened probiotic yogurt, tomatoes, broccoli and spinach. Of
course, plenty of water is also essential when fighting off a UTI.
Spirituality:
Encourage client to communicate and pray to God.
Contact No. (044) 463-0825

www.neust.edu.ph
Contact No. (044) 463-0825
Transforming Communities through Science and Technology
Email: neustmain@yahoo.com
www.neust.edu.ph

Toaz - Info Group 4 Cephalopelvic Disproportion 1stcheckingdocx PR

Uploaded by

Document Information

Original Description:

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Toaz - Info Group 4 Cephalopelvic Disproportion 1stcheckingdocx PR

Uploaded by

Copyright:

Available Formats

Republic of the PhilippinesNUEVA ECIJA UNIVERSITY OF

Cabanatuan City, Nueva Ecija, Philippines

Presented to the Faculty of the

In Partial Fulfillment of the

Requirements for the Subject

RELATED LEARNING EXPERIENCE

Students Name (Family, Given, MI)

Contact No. (044) 463-0825

The Problem and Its Setting

This study aims to provide knowledge about what

 Understand and discuss what is Cephalopelvic

Contact No. (044) 463-0825

Cephalopelvic disproportion (CPD) is a complication in

Fetal macrosomia is a medical term for when the fetus

Contact No. (044) 463-0825

In order to predict or verify Cephalopelvic

Even when a mother in experienced Cephalopelvic

Name: Celine Dior

Age: 19 years old

Height: 5’2 feet tall

Religion: Roman Catholic

Date Admission: August 24, 2020

Final Diagnosis: Caesarian Section II: Cephalopelvic

OB-Gyne Physician: Dra. Lirio

Contact No. (044) 463-0825

Cesarean delivery on first child. First Pregnancy in a

1.Antepartal / Prenatal Preparations.

Celine Dior managed to exercise less than 30 minutes

2.Significant Trimester Changes

 Striae Gravidarum (stretchmarks)

 Daily cravings (pineapple juice and ice cream)

Contact No. (044) 463-0825

 Sleeping schedule changed again (because of Shortness

 Quickening at least 10 times a day

Contact No. (044) 463-0825

Skull Generally round, with Round and no

Contact No. (044) 463-0825

Discussion of the table presented… in narrative format

Contact No. (044) 463-0825

(topics included in chapter 2)

Cephalo-Pelvic Disproportion arises whenever the pelvic

Contact No. (044) 463-0825

ANATOMY AND PHYSIOLOGY

Figure No.__: ___________

Vagina - is a muscular cannal approximately 10 cm long that

Contact No. (044) 463-0825

Uterus - it is the largest female reproductive organ, it

developing fetus, produces vaginal and uterine secretions,

Figure #__: ______

Contact No. (044) 463-0825

Cervix - opening of the uterus

The External Structure comprises of:

Labia Majora - or literally translates to large lips, this

Labia Minora - or small lips, lie just inside the labia

Bartholin’s glands - which are located beside the vaginal

Clitoris - this is a small, sensitive protrusion that is

SIGNS AND SYMPTOMS

Contact No. (044) 463-0825

BOOK BASED CLIENT BASED

Table #__: ______

Friedman describes prolonged labor or arrested

 Dehydration and exhaustion of the mother

Figure No.: _________

Figure #: ____

Table #: ____

Figure No.: ___