This is the way the pathogen transfers from the reservoir to the host. Perform measures to break the chain of infection and prevent infection. It is important to maintain the cleanliness of the affected areas by washing with mild soap and water. We and our partners use data for Personalised ads and content, ad and content measurement, audience insights and product development. Pt denies any uterus tenderness. When there is PROM the risk of serious infection is increased (1% versus 0.5% for women with intact membranes). If your water breaks before 37 weeks, your provider will help you make the safest choice. 2023 Nurseslabs | Ut in Omnibus Glorificetur Deus! This includes precautions like bed rest, medications and frequent monitoring for infection or fetal distress. It can lead to significant perinatal morbidity, including respiratory distress syndrome, neonatal sepsis, umbilical cord prolapse, placental abruption, and fetal death. Interrupting the chain of infection (see image above) is an effective way to prevent the spread of infection. Buy on Amazon, Silvestri, L. A. These factors represent a break in the bodys normal first line of defense and may indicate an infection. If this activity does not load, try refreshing your browser. Susceptible host. Desired Outcome: The patient will prevent spread of infection to the rest of the body, as well as cross-contamination to other people by following treatment regimen for varicella infection. Tips to help you get the most from a visit to your healthcare provider: Knowledge of isolation can help patients and family members cooperate with specific precautions. The fluid may merely trickle or leak from the vagina in the absence of contractions. (2002). most successful method in teaching nursing students infection controlE-learning or lecture? Also, having inadequate resources, lack of knowledge, and being malnourished place an individual at high risk of developing an infection. Umbilical cord prolapse can occur without any risk factors. If it happens earlier, your provider weighs the risk of premature birth against the risks of complications such as infection. Please wait while the activity loads. NANDA International Nursing Diagnoses: Definitions & Classification, 2021-2023The definitive guide to nursing diagnoses is reviewed and approved by NANDA International. Color of respiratory secretions.Yellow or yellow-green sputum is indicative of respiratory infection. Continually assess for signs of infection. Allowing a pregnancy to continue after the membranes rupture increases your chances of infection and other complications. All Rights Reserved. Saunders comprehensive review for the NCLEX-RN examination. It's commonly called your "water breaking.". Other people can spread infections or colds to a susceptible patient (e.g., immunocompromised) through direct contact, contaminated objects, or air currents. 217: Prelabor Rupture of Membranes. PROM may occur if the uterus is over-stretched by malpresentation of the fetus, multiple pregnancy or excess amniotic fluid. We may earn a small commission from your purchase. Monitor fetal heart rate continuously. Without the protection of amniotic fluid, the pregnancy is at risk for other complications, including: Your pregnancy care provider weighs the risks of premature birth against the risks of infection and other complications before deciding when its best to deliver. These complications include respiratory issues and trouble staying warm. After body fluid exposure risk4. Encourage coughing and deep breathing exercises; frequent position changes.Helps reduce the stasis of secretions in the lungs and bronchial tree. Nursing Care Plans Nursing Diagnosis & Intervention (10th Edition)Includes over two hundred care plans that reflect the most recent evidence-based guidelines. Your provider will keep you in the hospital on bed rest and attempt to prolong the pregnancy. Pt denies any uterus tenderness. The formatting isnt always important, and care plan formatting may vary among different nursing schools or medical jobs. <> Hypoxia and asphyxia of the woman in labour is a common complication of prolonged PROM. Instruct visitors to cover mouth and nose (by using the elbows to cover) during coughing or sneezing; use tissues to contain respiratory secretions with immediate disposal to a no-touch receptacle; perform hand hygiene afterward. The best thing you can do is avoid smoking cigarettes, maintain a healthy pregnancy and attend all of your prenatal exams. 1. Which physician order will the nurse question? 12. Premature rupture of membranes (PROM) is the rupture of the fetal membranes before the onset of labor. Intraamniotic infection is a common condition noted among preterm and term parturients. Although corticosteroids are not indicated after 34 weeks gestation, physicians should prescribe appropriate antibiotics for group B streptococcus prophylaxis and should consider maternal transport to a facility skilled in caring for premature neonates, if possible. It depends on factors like the age of the pregnancy and how much amniotic fluid is left. Inadequate primary defenses such as broken skin. Nursing Care Plan for Premature Rupture of the Membranes Patient: Mrs. Anna Care Plan By: Date Initiated: April 21, 2021 Case Study: Mrs. Anna is a 24-year-old pregnant patient that went to the Labor and Delivery triage area complaining, saying "I felt a sudden gush of water and I constantly feel wet". Women given this combination were more likely to stay pregnant for three weeks despite discontinuation of the antibiotics after seven days. The consent submitted will only be used for data processing originating from this website. % Goal. 9. Reservoir. Friction and running water effectively remove microorganisms from hands. A pathogen can be a bacterium, virus, fungus, parasite, or any other microorganisms. Antibiotics to prevent infection and prolong the pregnancy. Complications of preterm PROM are listed in Table 1.2,510. If you leave this page, your progress will be lost. The complications from prematurity are high when the fetus is fewer than 34 weeks gestation. When the latent period (time between rupture of membranes and onset of labor) is less than 24 hours, the risk of infection is low. While many people are at risk for infection in the community, about 1.7 million patients acquire healthcare-associated or nosocomial infections, with a death record of 98,000 annually. When the pathogen reaches the host, the body fights off the microorganism. Educate clients and SO (significant other) about appropriate cleaning, disinfecting, and sterilizing items. Cleveland Clinic is a non-profit academic medical center. Administration of corticosteroids after 34 weeks gestation is not recommended unless there is evidence of fetal lung immaturity by amniocentesis. The longer the time between membrane rupture and labor, the higher the risk of an infection. Buy on Amazon. Your healthcare provider may call it prelabor rupture of membranes. Prelabor is the newer, preferable term because it describes membrane rupture before labor starts prelabor rupture without implying prematurity. The gestational age of the fetus and estimates of viability affect management. Anna Curran. PPEs protect carers and prevent the transfer of infection to other people. Registered Nurse, Free Care Plans, Free NCLEX Review, Nurse Salary, and much more. All Rights Reserved. When preterm PROM is suspected, it is important to avoid performing a digital cervical examination; such examinations have been shown to increase morbidity and mortality.14,15 Digital cervical examinations also cause an average nine-day decrease in the latent period.16 Shortening of the latent period may lead to increased infectious morbidity and sequelae from preterm labor. Intervention #2. She states the she is 37 weeks along and is nervous about the gush of water she experienced so she decided to come to the L&D triage area. Your water breaking isnt something you can control. Approximately 90% of people will go into spontaneous labor within 24 hours if theyre between 37 and 40 weeks pregnant when their water breaks. 1 0 obj A temperature of greater than 37.7 (99.8 F) may indicate infection; a very high temperature accompanied by sweating and chills may indicate septicemia. Its important to note that if you already have an infection at the time of rupture or develop one afterward, delivery is necessary. Theyll also monitor the fetuss heart rate and movement to make sure it isnt in distress. Adequate sleep is an essential modulator of immune responses. 13. Its normal for the membranes to break by themselves, but this usually happens after labor starts. 4. Antibiotic may protect against the development of chorioamnionitis in women at risk. Educate patient on the signs of infection such as the following: Changes in cough or having a new cough. No edema is present and UA comes back as negative. Guppy, M. P., Mickan, S. M., Del Mar, C. B., Thorning, S., & Rack, A. VS HR 85, BP 130/82, Temp. Promote proper positioning or regular position changes. 9500 Euclid Avenue, Cleveland, Ohio 44195 |, Important Updates + Notice of Vendor Data Event, (https://www.midwife.org/acnm/files/ACNMLibraryData/UPLOADFILENAME/000000000233/PS-Prelabor-rupture-of-membranes-FINAL-22-MAR-18.pdf), (https://www.ncbi.nlm.nih.gov/books/NBK532888/). Here are the common causes of infection and factors that place a patient at risk for infection: Inadequate primary defenses (e.g., break in skin integrity, tissue damage). However, a premature birth also comes with risks. A 24 year old pregnant female presents to the L&D triage area complaining of gush of water and constantly feeling wet. The newborn's immune system is immature and can not yet protect against pathogens - at least for the first few months. According to the patients last menstrual period she is indeed 37 weeks along. Interprofessional patient problems focus familiarizes you with how to speak to patients. The sixteenth edition includes the most recent nursing diagnoses and interventions from NANDA-I 2021-2023 and an alphabetized listing of nursing diagnoses covering more than 400 disorders. Continuously monitor maternal and fetal vitals. If hands were not in contact with anyone or anything in the room, use an alcohol-based hand rub and rub until dry. Other signs of infection can help raise suspicion so tests can be conducted to confirm the presence of infection. If this happens after 37 weeks of pregnancy, your pregnancy care provider will deliver your baby. It involves collecting a fluid sample and looking at it under a microscope. Giving antibiotics to patients with preterm PROM can reduce neonatal infections and prolong the latent period. She denies having any labor contractions. Nurses Pocket Guide: Diagnoses, Prioritized Interventions, and Rationales Quick-reference tool includes all you need to identify the correct diagnoses for efficient patient care planning.