NANDA labor and delivery.

[sugarbush]

Okay, I just registered here and hope reading here teaches me some things.

I am in an ADN program and need help with a care plan for labor and delivery.

I am revising a care plan and my clinical instructor wants my top priority to be "preventable fetal/maternal injury" Our cox books does not have as Nanda for it. So what should I inclued for goals, and interventions?

[Daytonite, BSN, RN]

an anticipated diagnosis is written as "risk for maternal injury", "risk for fetal injury". lots of things can go wrong during labor and delivery. pick something. follow these guidelines in how you write the interventions: https://allnurses.com/forums/2751313-post8.html. goals are always the predicted results you expect to see when your interventions are performed as ordered. so, if these interventions are to prevent an injury from occurring, it seems that the logical goal would be for the injury not to occur.

[sugarbush]

Okay here is my problem.

Client as oligohydramios, with fetal distress. She was delivered by c-section that day.

I can write risk for maternal injury R/T preterm caesarian delivery.

I can only use a short term goal, no long term because I will not beable to evaluate a long term goal.

[Daytonite, BSN, RN]

ob was not my area of practice, but looking up the definition of oligohydromnios in my copy of taber's cyclopedic medical dictionary it states it is "complication of pregnancy defined as the volume of the amniotic fluid being less than 300 ml during the third trimester of pregnancy. this condition is associated with a high probability of post-maturity, fetal growth retardation, congenital anomalies and perinatal mortality." if the mother had a c-section, then her risk is for the complications following a c-section. the immediate risk to the fetus is premature delivery and the complications of that.

just doing a search for oligohydramnios netted these sites:

• http://www.marchofdimes.com/professionals/14332_4536.asp - amniotic fluid abnormalities (from the march of dimes). in this article it states that
  • "what complications can polyhydramnios cause for mother and baby?
    • women with minor polyhydramnios experience few symptoms. however, those who are more severely affected may have abdominal discomfort and breathing difficulties as a result of the uterus crowding the abdominal organs and lungs.
      
    • polyhydramnios may increase the risk of pregnancy complications including:
      
      • premature delivery
        
      • prom
        
      • placental abruption (the placenta partially or completely peels away from the uterine wall before delivery)
        
      • stillbirth
        
      • postpartum hemorrhage (severe bleeding after delivery)
        
      • fetal malposition (the baby is not lying in a head-down position and may need to be delivered by cesarean section)"

  [*]http://www.emedicine.com/radio/topic898.htm - oligohydramnios

  [*]http://www.medscape.com/viewarticle/551032 - oligohydramnios at term: a case report

  [*]http://www.emedicine.com/ped/topic1854.htm - polyhydramnios and oligohydramnios; the pediatric perspective