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Related Concept Videos

Documentation of Nursing Diagnosis01:10

Documentation of Nursing Diagnosis

The nurse documents nursing diagnoses and enters them into the patient record. The identified patient's nursing diagnosis is either written out with a plan of care or entered into the electronic health record.
In some settings, data-driven computerized decision support systems are in place, allowing for more accurate nursing diagnoses. The database within one of these systems includes diagnostic labels defining characteristics, activities, and indicators for nursing. A nurse enters assessment...
Formulating and Validating Nursing Diagnosis II01:25

Formulating and Validating Nursing Diagnosis II

Nursing diagnoses represent a problem validated by major defining characteristics. There are four categories of nursing diagnoses: problem-focused, risk, health promotion or wellness, and syndrome. The anatomy of a nursing diagnosis includes three components: problem statement or diagnostic label, defining characteristics, and related factors.
Risk nursing diagnoses represent clinical judgments of an individual, family, or community more vulnerable to developing the health problem than others...
Formulating and Validating Nursing Diagnosis I01:26

Formulating and Validating Nursing Diagnosis I

A nursing diagnosis is written when the nurse recognizes a cluster of essential patient data indicating health problems treated with independent nursing interventions. The standardized terminologies of a nursing diagnosis help nurses identify and treat patients' problems. Every electronic health record that uses nursing diagnosis must employ standard diagnostic terminology. Developing an efficient, individualized care plan begins with accurate nursing diagnoses.
There are thirteen domains for...
Nursing Diagnosis01:22

Nursing Diagnosis

Following assessment, a nursing diagnosis is the next step in the nursing process. It begins after the nurse has collected and recorded the patient data. The purpose of diagnosing is to identify how the client responds to actual or potential health processes, identify factors that bestow or that cause health problems, the etiologies, and identify resources or strengths the individual, group, or community can draw on to prevent or resolve problems.
The nursing diagnosis focuses on evidence-based...
Endoscopic Studies II: Thoracocentesis01:26

Endoscopic Studies II: Thoracocentesis

Thoracentesis(Thoracocentesis), commonly known as pleural tap, is a medical procedure where a 22 gauge needle is inserted into the pleural space, the area between the lung and chest wall. This procedure is commonly performed to diagnose or treat various respiratory disorders.
Description
Excess pleural fluid or air may accumulate in some respiratory disorders in the thoracic cavity. To treat pleural effusion, a physician conducts thoracentesis by carefully piercing the chest wall and entering...

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Electromyometrial Imaging of Uterine Contractions in Pregnant Women
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Electromyometrial Imaging of Uterine Contractions in Pregnant Women

Published on: May 26, 2023

Failed labor induction: toward an objective diagnosis.

Dwight J Rouse1, Steven J Weiner, Steven L Bloom

  • 1From the Department of Obstetrics and Gynecology at the University of Alabama at Birmingham, Birmingham, Alabama; University of Texas Southwestern Medical Center, Dallas, Texas; University of Utah, Salt Lake City, Utah; The University of Texas Health Science Center at Houston, Houston, Texas; University of Pittsburgh, Pittsburgh, Pennsylvania; Northwestern University, Chicago, Illinois; Wayne State University, Detroit, Michigan; Drexel University, Philadelphia, Pennsylvania; Brown University, Providence, Rhode Island; Case Western Reserve University-MetroHealth Medical Center, Cleveland, Ohio; University of North Carolina at Chapel Hill, Chapel Hill, NC; Columbia University, New York, NY; Wake Forest University Health Sciences, Winston-Salem, North Carolina; The Ohio State University, Columbus, Ohio; the University of Texas Medical Branch, Galveston, Texas; and The George Washington University Biostatistics Center, Washington, DC, and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland.

Obstetrics and Gynecology
|January 22, 2011
PubMed
Summary
This summary is machine-generated.

Labor induction with oxytocin after membrane rupture may not be a failure if the latent phase lasts up to 12 hours. Nearly 40% of women achieved vaginal delivery even after prolonged latent phase, indicating potential for successful outcomes.

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Area of Science:

  • Obstetrics and Gynecology
  • Reproductive Medicine
  • Maternal-Fetal Medicine

Background:

  • Labor induction is common, especially with an unfavorable cervix.
  • The duration of the latent phase of labor and its impact on outcomes require further investigation.
  • Oxytocin is a key agent in labor induction, but its optimal use in the latent phase is debated.

Purpose of the Study:

  • To assess maternal and perinatal outcomes in women undergoing labor induction with an unfavorable cervix.
  • To specifically evaluate the effect of oxytocin administration duration during the latent phase after membrane rupture on delivery outcomes.

Main Methods:

  • Secondary analysis of a randomized multicenter trial.
  • Inclusion criteria: nulliparous women at or beyond 36 weeks gestation, undergoing induction with a cervix ≤2 cm dilated and not fully effaced.
  • Latent phase defined as ending at 4 cm dilation/90% effacement or 5 cm dilation.

Main Results:

  • 1,347 women analyzed; overall vaginal delivery rate was 63.2%.
  • Nearly 70% exited the latent phase within 6 hours of oxytocin and membrane rupture; only 5% remained after 12 hours.
  • 39.4% of women remaining in the latent phase after 12 hours achieved vaginal delivery. Neonatal outcomes were not associated with latent phase duration, but prolonged duration correlated with increased risk of chorioamnionitis, endometritis, or uterine atony.

Conclusions:

  • Prolonged latent phase (up to 12 hours) of labor induction with oxytocin after membrane rupture can still result in a significant rate of vaginal delivery.
  • It is advisable to continue oxytocin administration for at least 12 hours before considering labor induction a failure in the latent phase.
  • Maternal risks like chorioamnionitis and uterine atony increase with longer latent phase duration.