Nursing Dx help PLEASE! r/t shortened cervix?

HollyUTM · Oct 20, 2004

Ok, we have to write a nursing dx for every abnormal finding on our postpartum assessments. One thing is a shortened cervix with funneling...but how would I write a nursing diagnosis for this? Can't say that exactly because that is a medical issue...
UGH...I'm thinking Risk for Injury but not sure...and if so how would I word the risk factors? UGH!!!! Any help would be GREATLY appreciated!!!! :balloons:

I really don't know the answer to that, but shortening of the cervix is effacement, and me personally if a woman's cervix was effaced postpartum I would probably either think of the injury factor that you mentioned or infection. possibly risk for injury due to infection. But like I said, I have no idea, I'm kind of pulling that out of where the sun doesn't shine, if ya know what I mean. I might have just made myself sound like a complete idiot, but if it were my guess, I'd say something about infection due to the cervix not being there to block microorganisms from entering the uterus. Again, I guessed. Hope that somehow helped and that you can make sense of it! :)

Holly

malenurse1 · Oct 20, 2004

Ok, we have to write a nursing dx for every abnormal finding on our postpartum assessments. One thing is a shortened cervix with funneling...but how would I write a nursing diagnosis for this? Can't say that exactly because that is a medical issue...
UGH...I'm thinking Risk for Injury but not sure...and if so how would I word the risk factors? UGH!!!! Any help would be GREATLY appreciated!!!! :balloons:

Maybe I am wrong, and please correct me if I am, but isn't an effaced cervix a "normal" postpartum finding? It had to efface and dilate to allow the baby to pass through the birth canal. It, like everything else, won't return to its prepregnancy state overnight. You also have to factor what was normal for her prepregnancy. Does her chart indicate whether her cervix was a little short to begin with. You may have to talk with her MD to find out this information.

palesarah · Oct 20, 2004

I've only been an OB nurse for a little over a year, but in my (limited) experience, the term "shortened cervix" is usually used not to describe normal cervical effacement but a preterm finding in which the cervix is measuring unusually short (the average non-pregnant or pre-labor cervix measures about 3cm/1 inch long). It is usually discovered in ultrasound. Funneling of the membranes are another abnormal prenatal finding which may precede premature rupture of membranes or premature labor (the membranes are either funneling into the cervix or bulging through like a figure 8). (Hopefully Deb or another OB goddess will throw in a better explanation; I have had very limited experience with patients with these diagnoses)

So if a patient was at risk for or experiencing premature ROM or labor, some appropriate NDs might be anxiety, fear, risk for infection (esp if PROM), anticipatory grieving, social isolation- think about things a woman on bedrest or who fears for the outcome of a wanted pregnancy may be feeling.

malenurse1 · Oct 20, 2004

Thanks for the enlightenment palesarah. I always consider it agood day when I learn something new. Now today is a good day!

cherokeesummer · Oct 21, 2004

Thanks all! Yep, sorry! It was an antepartum finding, not a postpartum sorry! :):)

Yeah, anxiety, fear, etc would be good...r/t the possibility of premature rom. The wierd thing is she had to be induced at 40.6 weeks and had a c-section for failure to progress...I would have thought preterm labor or something like tha but I'm new to this :):)

Thanks for your help all!!!!

TDub, MSN, EdD · Oct 21, 2004

That happens a lot--I think the poor cervix just clamps down after all the hammering we do and won't open when it's time.

I would go with a couple of nursing diagnoses:

Risk for premature labour: lots of nursing actions you can do.

Risk for impaired parenting 2o to prematurity

Knowledge deficit: does she understand what may happen?

Risk of infection or DVTs r/t bedrest

That's just what occurs to me off the top of my head.