Question

The client is admitted with fetal demise. A diagnosis of missed abortion requires that the fetus be evacuated by induction of labor. If the physician uses prostaglandin, the nurse should anticipate that the client will: ? A. Complain of nausea ? B. Become constipated ? C. Need treatment with potassium supplementation ? D. Require that a Foley catheter be inserted

Short answer

Answer: The nurse should anticipate that the client might complain of nausea after the administration of prostaglandin for the induction of labor.

Step-by-step solution

Understanding Prostaglandin

Prostaglandin is a hormone-like substance that plays a crucial role in the induction of labor. When used for this purpose, it helps to ripen the cervix, soften the cervical tissues, and initiate contractions.

Analyzing the Options

Now, let's analyze each of the given options: A. Complain of nausea: Prostaglandin can cause some side effects, and nausea is one of them. It is important to be aware of this potential side effect so the nurse can provide appropriate care to the client. B. Become constipated: Prostaglandin does not typically cause constipation as a side effect. This option is not likely to be correct. C. Need treatment with potassium supplementation: Prostaglandin does not generally cause an imbalance in potassium levels. Hence, the need for potassium supplementation is an unlikely outcome. D. Require that a Foley catheter be inserted: A Foley catheter is a urinary catheter, often used to drain the bladder during labor, especially for patients with epidurals. Prostaglandin alone will not necessarily require a Foley catheter to be inserted.

Selecting the Correct Answer

Based on the analysis of the given options and the effects of prostaglandin, the most accurate option is: ? A. Complain of nausea The nurse should anticipate that the client might complain of nausea after the administration of prostaglandin for the induction of labor.

Key concepts

Fetal Demise

Fetal demise, sometimes referred to as intrauterine fetal death, occurs when a fetus dies during the pregnancy after the 20th week of gestation. Distinct from a miscarriage, which generally happens before the 20-week mark, fetal demise can be emotionally and physically taxing for the expectant mother. The cause of fetal demise is not always known, but it can be due to genetic issues, placental problems, or maternal health complications.

From a medical perspective, when fetal demise is diagnosed, the body does not always spontaneously expel the fetus. It becomes necessary to induce labor to prevent complications, such as infection or clotting disorders, in the mother. Prostaglandins, due to their role in softening the cervix and promoting uterine contractions, are often used to medically manage a fetal demise by inducing labor.

Missed Abortion

A missed abortion is a condition where the fetus has stopped developing and unfortunately died, but the body does not immediately recognize the loss or expel the pregnancy tissue. This can occur without the typical symptoms of miscarriage such as bleeding or cramping. Often, a missed abortion is detected through an absence of fetal heartbeat during an ultrasound scan.

In such situations, a decision might be made to allow the body to naturally expel the fetal tissue or to use medications, such as prostaglandins, to induce labor and complete the miscarriage process. This medical intervention is key to avoiding potential complications, including infection or prolonged bleeding for the mother.

Nursing Care

Nursing care during the induction of labor with prostaglandins is multifaceted. Nurses play a crucial role in providing both emotional support and physical care to the patient. Close monitoring of vital signs, uterine contractions, and fetal heart rate (if applicable) is vital to ensure the safety of the patient during labor induction following fetal demise or missed abortion.

Attention to the patient's comfort, pain management, and emotional well-being is an integral aspect of nursing care during this difficult time. It is important for the nurse to prepare for potential side effects of the medication, such as nausea or diarrhea, and provide appropriate interventions, such as antiemetics for nausea relief.

• Monitoring and managing side effects
• Providing emotional and psychological support
• Assessing and managing pain
• Keeping the patient informed about the procedures and progress

Side Effects of Prostaglandin

The administration of prostaglandins for labor induction can lead to several side effects. Among the more common ones, nausea is significant and often anticipated by healthcare providers. The patient should be monitored for this side effect, and appropriate interventions, such as administering anti-nausea medications, should be provided.

Other potential side effects of prostaglandin use include headaches, fever, diarrhea, and strong uterine contractions, which can be uncomfortable and require additional pain management strategies. It is vital for the nursing staff to anticipate these side effects and to take steps to manage them effectively to reduce patient discomfort and prevent further complications.

Understanding these side effects and their management is an essential part of providing comprehensive care during labor induction and ensuring the well-being of the patient through a challenging process.