A nurse is preparing to perform an amnioinfusion for a client who has oligohydramnios and a cord compression.
Which of the following are appropriate steps for this procedure? (Select all that apply.)
A.
Obtain informed consent from the client
B.
Insert an intrauterine pressure catheter into the uterus
C.
Infuse warmed sterile normal saline into the amniotic cavity
D.
Monitor the client’s temperature every 4 hours
E.
Assess the fetal heart rate and uterine activity continuously
The Correct Answer and Explanation is:
Correct Answers:
A. Obtain informed consent from the client
B. Insert an intrauterine pressure catheter into the uterus
C. Infuse warmed sterile normal saline into the amniotic cavity
E. Assess the fetal heart rate and uterine activity continuously
Explanation:
A. Obtain informed consent from the client: Before performing any invasive procedure, including amnioinfusion, obtaining informed consent is a crucial step. This ensures that the client understands the purpose, risks, benefits, and possible alternatives to the procedure. Informed consent respects patient autonomy and is a fundamental ethical and legal requirement in healthcare.
B. Insert an intrauterine pressure catheter into the uterus: In amnioinfusion procedures, an intrauterine pressure catheter (IUPC) is often inserted to monitor intrauterine pressure and accurately measure the volume of infused fluid. This helps to gauge the effectiveness of the amnioinfusion and to monitor for any potential complications, such as overdistension of the uterus.
C. Infuse warmed sterile normal saline into the amniotic cavity: The procedure involves infusing a sterile fluid, typically warmed normal saline or Ringer’s lactate, into the amniotic cavity through a catheter. This helps to relieve umbilical cord compression by increasing the amniotic fluid volume, which can improve fetal oxygenation and reduce the risk of adverse outcomes.
D. Monitor the client’s temperature every 4 hours: Although monitoring the client’s temperature is important in the broader context of labor and delivery to detect any signs of infection or other complications, it is not a specific requirement or focus during the amnioinfusion procedure itself. Typically, more frequent monitoring might be necessary depending on the clinical situation and hospital protocols.
E. Assess the fetal heart rate and uterine activity continuously: Continuous monitoring of the fetal heart rate and uterine activity is essential during and after the amnioinfusion procedure. This allows for real-time assessment of the fetal response to the infusion and ensures that the procedure is achieving its intended effect without causing adverse fetal or maternal effects.
Overall, amnioinfusion is a procedure aimed at improving fetal well-being in cases of oligohydramnios and cord compression. Adhering to these steps ensures the procedure is conducted safely and effectively.