유도분만케이스_ 분만통증, 체액부족, 감염위험성, 불안, 피로 (A+자료)

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"유도분만케이스_ 분만통증, 체액부족, 감염위험성, 불안, 피로"에 대한 내용입니다.

목차

Ⅰ. 문헌고찰
1. 유도분만의 정의 ························································································· p.1
2. 적응증과 금기증 ························································································· p.1
3. 옥시토신을 이용한 유도분만 ·············································································· p.2
4. 프로스타글란딘 ·························································································· p.2
5. 인공 양막파막술 ························································································· p.3
6. 준비사항 ································································································ p.3
7. 부작용/후유증 ··························································································· p.3

Ⅱ. 간호사정
1. 일반사항 ································································································ p.4
2. 동거가족 ································································································ p.4
3. 과거 건강력 ····························································································· p.4
4. 과거 산과력 ····························································································· p.5
5. 현재 산과력 ····························································································· p.5

Ⅲ. 분만과정 관찰 및 간호수행 기록
1. 산부입원 ································································································ p.7
2. 분만 제 1기 ···························································································· p.7
3. 분만 제 2기 ···························································································· p.8
4. 분만 제 3기 ···························································································· p.10
5. 분만 제 4기 ···························································································· p.10
6. 임상검사 ································································································ p.11
7. 사용약물 ································································································ p.14

Ⅳ. 간호과정
1. 우선순위에 따른 간호진단 ················································································ p.17
2. 간호과정Ⅰ······························································································· p.17
3. 간호과정Ⅱ ······························································································ p.20

Ⅴ. 참고문헌 ································································································ p.23

본문내용

1. 유도분만의 정의

진통이 없는 임신부에서 인공적으로 진통을 오게 하여 태아를 분만하는 방법이다. 태아 사망, 심한 임신중독증, 예정일이 많이 넘는 등으로 빨리 분만해야 되는데 저절로 진통이 오지 않을 때 주로 쓰인다. 소파수술할 시기를 넘어서 심한 태아 기형이 발견되는 등으로 임신중절을 해야 될 때 돌려 낳는 방법이기도 하다. 유도분만은 분만을 해야 되는데도 진통이 없을 때 진통 촉진제를 써서 진통을 유발하는 것이며, 자연진통이 있는 임신부는 촉진제를 쓰더라도 유도분만이라고 하지 않고 촉진을 시킨다고 말한다.
자궁경부의 숙화는 자궁수축에 앞서서 정상적으로 일어나는 생리반응이며 매우 복잡한 생화학적 과정을 포함하고 있다. 종종 자궁경부 숙화가 자궁수축을 유도하기도 하며, 지속적인 자궁수축이 결국 자궁경부의 숙화를 유도하는 경우가 있다. 하지만 일반적으로 분만유도를 위한 옥시토신의 사용은 자궁경부의 숙화가 선행되어야 하며, 그렇지 않을 경우 분만유도 실패율이 높다고 알려져 있다.
진단이 정확해야 되므로 유도분만을 시작하기 전에는 월경의 규칙성, 기초 체온, 배란 초음파검사, 태아 크기를 재는 초음파검사 등으로 임신 주 수를 확인하는 것이 매우 중요하다. 임신 42주 즉 분만 예정일에서 만 2주일이 지났는데 진통이 안 오면 촉진제를 쓰는 유도분만을 고려한다. 분만 예정일이 확실하다면 더욱 그렇다. 그러나 분만 예정일이 불명확하고 태아 상태가 정상이라면 무리하게 유도분만을 하는 것보다는 기다리면서 경과 관찰을 하는 것이 유리하다.
유도분만의 방법으로는 먼저 태아를 둘러싸고 있는 막을 인위적으로 터지게 하는 방법, 젖꼭지를 자극하는 방법 또는 피토신이라는 합성 옥시토신을 정맥으로 주사하는 방법 등이 있다. 그러나 피토신은 심한 분만 진통을 유발하거나 태아를 압박할 수 있기 때문에 정맥투여 시 태아 맥박 감시 장치로 태아 상태를 지속적으로 체크할 필요가 있다. 그 외에 젤이나 프로스타글라딘 호르몬이 함유되어 있는 좌약을 질에 삽입하여 자궁 경부가 열리게 한다.

참고 자료

https://gangnam.chamc.co.kr/health/culturecenter/childbirth/FAQ.cha?page=2&fcIdx=&search=UF_TITLE&keyword=
강남 차병원
http://www.amc.seoul.kr/asan/healthinfo/management/managementDetail.do?managementId=281
http://m.amc.seoul.kr/asan/mobile/healthinfo/disease/diseaseDetail.do?contentId=31950&diseaseKindId=C000012
서울아산병원
http://www.snuh.org/health/nMedInfo/nView.do?category=TREAT&medid=BB000050
서울대학교병원
https://ilsan.chamc.co.kr/health/contents/antepartum/examination.cha
일산 차병원
http://seoulmom.com/index.php?page=html&mc=127
대전서울여성병원
여성건강간호교과연구회, ⌜여성건강간호학. 2(10판)⌟, 수문사(2020)
황옥남 외8명, ⌜제7판 성인간호학 상권⌟, 현문사(2017)