3. What are the fetal complications associated with macrosomia (9)?
Answer
- Shoul- der dystocia (head is born but anterior shoulder cannot pass through cervix, if
unresolved can lead to death)
4. What does nursing assessment in preparation for delivery look like in macrosomia (4)?
Answer
, - Want to identify before labor onset to reduce the occurrence of associated maternal fetal
problems.
- Evaluation of maternal pelvis if a large fetus is suspected
- Estimation of fetal size
- Ultrasonography may be indicated
5. What does nursing management look like during delivery with macrosomia
(7)?
Answer
- Unexpected shoulder dystocia is critical problem
- assist woman in McRoberts maneuver or apply suprapubic pressure to aid in the birth of the
fetal shoulders
- Application of fundal pressure is contraindicated
- Evaluation of rates of cervical dilation and fetal descent
- Continuous fetal monitoring
report any sign of labor dysfunction or non-reassuring fetal status to HCP
- Lack of fetal descent should raise suspicion that infant may be too large for vaginal birth
- Support and inform laboring woman and her partner
6. What does neonatal assessment look like with macrosomia (4)?
Answer
- Inspect newborn for cephalohematoma, Erb palsy, and fractured clavicles
- Inform nursery staff of any problems
- Close monitoring for cerebral, neurologic, and motor problems
- Monitor BG
7. What does maternal care/assessment look like with macrosmia (2)?
Answer
- Ex- pect uterine atony and boggy (soft) uterus
- Monitor for and treat uterine hemorrhage
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