risk for infection related to rupture of membranes care plan

You also have a higher chance of having your baby born early. Reime, M. H., Harris, A., Aksnes, J., & Mikkelsen, J. Nursing Diagnosis Manual: Planning, Individualizing, and Documenting Client CareIdentify interventions to plan, individualize, and document care for more than 800 diseases and disorders. ]7W|+;JqWfPAU2M0a Long fingernails tend to contain more bacteria. It is also harmful for pregnant women as it can affect the unborn baby. 17. Copyright 2006 by the American Academy of Family Physicians. In most cases, this occurs near term, but when membrane rupture occurs before 37 weeks gestation, it is known as preterm PROM. Methods A prospective cohort study was completed . Premature rupture of membranes (PROM) is the rupture of the fetal membranes before the onset of labor. Assess and monitor nutritional status, weight, history of weight loss, and serum albumin.Patients with inadequate nutrition may be anergic or unable to muster a cellular immune response to pathogens, making them susceptible to infection. No edema is present and UA comes back as negative. Studies show PPROM is more likely to affect twin pregnancies. No studies are available comparing delivery with expectant management when patients receive evidence-based therapies such as corticosteroids and antibiotics. PATIENT EDUCATION 1. Various health problems and conditions can create a favorable environment that would encourage the development of infections. 12. Wound healing alterations caused by infection. Not completing the prescribed antibiotic regimen can lead to drug resistance in the pathogen and reactivation of symptoms. Investigate the use of medications or treatment modalities that may cause immunosuppression.Antineoplastic agents, corticosteroids, and so on can suppress immune function. Do not treat a patient based on this care plan. A lack of sleep can weaken immunity and increased susceptibility to infection. Cleveland Clinics Ob/Gyn & Womens Health Institute is committed to providing world-class care for women of all ages. Improving compliance with hand hygiene in hospitals. Ackley, B. J., Ladwig, G. B., Makic, M. B., Martinez-Kratz, M. R., & Zanotti, M. (2020). Observe and report if an older client has a low-grade fever or new onset of confusion. Umbilical cord compression is common (32 to 76 percent)7 with preterm PROM before 32 weeks gestation; therefore, at least daily fetal monitoring is indicated. It involves placing a drop of your vaginal fluid on the strip of paper and waiting to see if the paper turns blue. 4 0 obj Any suspicious drainage should be cultured; antibiotic therapy is determined by pathogens identified. Educate patient on the signs of infection such as the following: Changes in cough or having a new cough. Ideally, these treatments allow your pregnancy to progress to at least 34 weeks. Other symptoms include a fast heart rate, sore or painful uterus, and amniotic fluid that smells bad. Educating the patient about the disease can raise confidence and understanding of the importance of sticking to the guidelines. If labor does not begin or the fetus is judged to be preterm or at risk for infection, explain treatments that are likely to be needed. Coughing is an effective method to expectorate mucus build up to prevent infection. She denies having any labor contractions. Treatment depends on the gestational age of the pregnancy (a term to describe how far along your pregnancy is), the health of the fetus and how severe your condition is. These are the classic signs of infection. Cleveland Clinic is a non-profit academic medical center. A 24 year old pregnant female presents to the L&D triage area complaining of gush of water and constantly feeling wet. Speculum examination is preferred. TANYA M. MEDINA, M.D., AND D. ASHLEY HILL, M.D. Varicella infection is generally treated using antiviral therapy. Coming to a Cleveland Clinic location?Hillcrest Cancer Center check-in changesCole Eye entrance closingVisitation and COVID-19 information, Notice of Intelligent Business Solutions data eventLearn more. Fever during labor. Please wait while the activity loads. She takes the topics that the students are learning and expands on them to try to help with their understanding of the nursing process and help nursing students pass the NCLEX exams. Next steps. Long-term tocolysis is not indicated for patients with preterm PROM, although short-term tocolysis may be considered to facilitate maternal transport and the administration of corticosteroids and antibiotics. Ideally, the sac breaks during labor. Continue with Recommended Cookies. NANDA International Nursing Diagnoses: Definitions & Classification, 2021-2023The definitive guide to nursing diagnoses is reviewed and approved by NANDA International. You may ask patients during history taking when they were last immunized. Desired Outcome: The patient will demonstrate lifestyle changes to promote a safe environment. Maternal infection may occur during labor (chorioamnionitis) or after birth (postpartum endometritis), and prolonged rupture of membranes and multiple vaginal examinations are known risk factors for the development of maternal and neonatal infection. Some physicians are concerned that not performing a digital examination may lead to the misdiagnosis of advanced preterm labor with imminent delivery, which has important implications for patients who require transfer to a tertiary care center; however, a prospective comparison17 found that the difference between digital and speculum examinations was not clinically significant. Assist clients in carrying out appropriate skin and oral hygiene. We and our partners use data for Personalised ads and content, ad and content measurement, audience insights and product development. Assess immunization status and history. Preterm PROM is not a contraindication to vaginal delivery. Assess for the presence of local infectious processes in the skin or mucous membranes. We do not endorse non-Cleveland Clinic products or services. Studies have shown that labor induction clearly is beneficial at or after 34 weeks gestation. Risk for Infection is related to the increased susceptibility to infection. Teach the patient/ carer the proper application of non-stick bandages over the affected areas can also help prevent the spread of rash and further infection. Change dressing and bandages that are soiled or wet. To assess for the evidence of ongoing infection. Interrupting the chain of infection (see image above) is an effective way to prevent the spread of infection. These are behaviors necessary to prevent the spread of infection. Additionally, without the protection of amniotic fluid and the amniotic sac, the fetus and your uterus are at risk for infection. Physicians should advise patients and family members that, despite these efforts, many patients deliver within one week of preterm PROM.4 Contraindications to conservative therapy include chorioamnionitis, abruptio placentae, and nonreassuring fetal testing. Instruct client not to share personal care items (e.g., toothbrush, towels, etc.). Recommend the use of soft-bristled toothbrushes and stool softeners to protect mucous membranes. If it occurs before 37 weeks of pregnancy (preterm PROM), your provider must weigh the risks of premature birth with the risk of complications such as infection and umbilical cord compression. Basic and effective defense against the fetus contracting an infection is lost and the risk of ascending intrauterine infection, known as chorioamnionitis, is increased. Your provider may induce labor with medications or allow your labor to progress on its own. St. Louis, MO: Elsevier. ACOG practice bulletin no. Your membranes are sometimes called bag of waters, which is where the term water breaking comes from. <> Obtain smear specimens from vagina and rectum as prescribed to test for betahemolytic streptococci, an organism that increases the risk to the fetus. This postpartum . Pt denies any uterus tenderness andthe patient states she felt the babys last movement about an hour ago. Redness, swelling, increased pain, purulent discharge from incisions, injury, and exit sites of tubes (IV tubings), drains, or catheters. The risk of chorioamnionitis with term PROM has been reported to be less than 10% and to increase to up to 40% for latency periods exceeding 24 hours (Seaward, P.G et al, 1997) Arrowsmith, V. A., Maunder, J. Which of the following increases the risk of placental abruption? PROM is rupture of the chorion and amnion 1 hour or more before the onset of labor. In this new version of a pioneering text, all introductory chapters have been rewritten to provide nurses with the essential information they need to comprehend assessment, its relationship to diagnosis and clinical reasoning, and the purpose and application of taxonomic organization at the bedside. 3.4. Color of respiratory secretions.Yellow or yellow-green sputum is indicative of respiratory infection. Figure 1 is an algorithm for management of preterm PROM. If its yellow or has an odor, its likely urine. As described above, corticosteroids and antibiotics are beneficial when administered to patients with preterm PROM, but no studies of these therapies combined with tocolysis are available. Administer antiviral medication as prescribed. These data were collected via a 14 county, 23 hospital population based Perinatal Data System. This involves your provider inserting a speculum into your vagina. How do you develop a nursing care plan? Also, impart these duties to the patient and their significant others and know the instances when to perform hand hygiene or 5 moments for hand hygiene:1. You have not finished your quiz. Medical-surgical nursing: Concepts for interprofessional collaborative care. 6. Obtain a travel history from clients. 10. Antimicrobials are widely used to treat infections when susceptibility is present. | New Nurse STORYTIME & Tips, NCLEX NGN Study Plan Strategy for Case Studies | Next Generation NCLEX, Left-Sided Heart Failure vs Right-Sided Heart Failure Pathophysiology Nursing NCLEX Review, Left-Sided vs. Right-Sided Heart Failure Nursing Review, Next Generation NCLEX Case Study Sample Questions, Wheezes (High-Pitched) Lung Sound Nursing Review. Berman, A., Snyder, S. J., Kozier, B., Erb, G. L., Levett-Jones, T., Dwyer, T., & Parker, B. Teach the importance of avoiding contact with individuals who have infections or colds. Nursing Care Plan Name of the Patient: Mrs. FlorenceMedical Diagnosis: Post CSNursing Diagnosis: Risk for infection related to premature rupture of membranesShort-Term Goal: Within the shift, patient will be able to identify ways to reduce risk for infection. The leading cause of death associated with PROM is infection. Patients with PROM present with leakage of fluid, vaginal discharge, vaginal bleeding, and pelvic pressure, but they are not having contractions. If infection occurs, teach the patient to take anti-infectives as prescribed. In addition, the physician should observe closely for fetal or maternal tachycardia, oral temperature exceeding 100.4F (38C), regular contractions, uterine tenderness, or leukocytosis, which are possible indicators of amnionitis. Washing between procedures reduces the risk of transmitting pathogens from one area of the body to another. Anna Curran. Maternal fever, fetal tachycardia, and malodorous discharge may indicate infection. These complications include respiratory issues and trouble staying warm. If hands were not in contact with anyone or anything in the room, use an alcohol-based hand rub and rub until dry. Assess the patients skin on his/her whole body. We may earn a small commission from your purchase. Knowledge of ways to reduce or eliminate germs reduces the likelihood of transmission. The major symptom is fever. 10. It is important to verify the patients estimated due date because this information will direct subsequent treatment. Physicians should ask whether the patient is contracting, bleeding vaginally, has had intercourse recently, or has a fever. Appropriate evaluation and management are important for improving neonatal outcomes. Corticosteroids should be given to patients with preterm PROM between 24 and 32 weeks gestation to decrease the risk of intraventricular hemorrhage, respiratory distress syndrome, and necrotizing enterocolitis. Magnesium sulfate to help the fetuss brain. Once the sac breaks, you have an increased risk for infection. Some of our partners may process your data as a part of their legitimate business interest without asking for consent. Preterm Premature Rupture of Membrane - NursingAnswers.net When the latent period (time between rupture of membranes and onset of labor) is less than 24 hours, the risk of infection is low.
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