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Incompetent Cervix (Picmonic)
Incompetent Cervix Pathochart (Cheat Sheet)
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Hello, everyone. We are going to be discussing a nursing plan for incompetent cervix. So, here we go. First, we're going to go over the pathophysiology. So, this is the premature thinning and dilation of the tubular end of the uterus or the cervix. When the cervix is weakened, it cannot withstand the pressure of the growing fetus. Therefore it begins to open too early. Some nursing considerations: obtain gynecological history, assess for vaginal bleeding, encourage decreasing physical activity, administer medications, assist with an amniocentesis, and educate on nutrition and lifestyle. Some desired outcomes are maintaining viable pregnancy and avoiding a preterm delivery or miscarriage.
So as we go through the care plan, we're going to be discussing a lot of the subjective data that we're going to see in a patient and some objective data. So one of the things that you're going to hear a patient talk about is some cramping. That's very, very common. Also any sort of changing of discharge. Those are going to be some of the big things that they're going to talk about. And also any sort of back pain is also going to be a complaint by the patient. You might also see some light vaginal bleeding or some spotting from the patient as well.
Some interventions that we're going to talk about. We want to get a full gynecological history from the patient. So with this, you're going to want to see about their previous pregnancies, any difficult births that the patient may have had, any sort of gynecological treatments that the patients had, any abnormal pap smears and any other sort of history that might help determine the risk for this patient. We want to assess for a vaginal discharge. So you want to make sure that you're noting the volume and you are noting the color and the consistency of the discharge. Patients often report a change in the vaginal discharge, usually from a clear color to like a white, or a pink color, maybe even tan. There might be an increase in discharge or vaginal bleeding. You want to get a history of substance abuse; patients typically are on medications or substances that may cause premature dilation of the cervix. Some other interventions that we want to think about with these patients, we want to make sure we're encouraging them to decrease physical activity and avoid any exercise or intercourse and to take frequent breaks, because ,unfortunately, any sort of continued pressure that is put on the cervix can cause premature dilation, thus increasing the risk of preterm labor. We also want to administer any sort of medications when it's appropriate, such as tocolytics or steroids as they are going to help stop preterm labor and also help the baby's lungs mature faster. Also analgesics as they may be complaining of any sort of pain, especially after having a procedure if needed. They may do an amniocentesis, which may be required to determine if a patient's eligible for the cerclage procedure. When they have a cerclage placement, it's going to help keep that cervix closed. They will have stitches that are placed by the physician and it will help prevent any sort of preterm labor. And usually they’ll be taken out the third trimester before birth. Other things you want to consider are nutrition and lifestyle education. You want to make sure the mom's maintaining a healthy weight gain during pregnancy and avoid any sort of smoking or drinking alcohol.
So some key points that we want to be sure we're going over patho and etiology of an incompetent cervix. Cervical insufficiency is the premature thinning and dilation of the tubular end of the uterus or cervix damage to the cervix either through surgery, dilation and curettage or previous difficult burst may result in an incompetent cervix. Subjective and objective data. So what are we going to see with these patients? They're going to have pelvic pressure, abdominal cramping, backache, changes in vaginal discharge, and light vaginal discharge. Making sure you note the volume, color, and consistency. You want to decrease activity and give medication. So encourage decreased activity, avoiding exercise, and intercourse, taking frequent breaks. You may be giving tocolytics that will help with preterm labor and steroids with the preterm labor for lung maturity. Cerclage placement prevents preterm labor. You want to make sure you're educating the patient to maintain healthy weight gain during pregnancy and also avoid smoking and drinking alcohol.
You guys are doing wonderful. Thank you so much. We love you guys. Go out, be your best self and as always happy nursing.
So as we go through the care plan, we're going to be discussing a lot of the subjective data that we're going to see in a patient and some objective data. So one of the things that you're going to hear a patient talk about is some cramping. That's very, very common. Also any sort of changing of discharge. Those are going to be some of the big things that they're going to talk about. And also any sort of back pain is also going to be a complaint by the patient. You might also see some light vaginal bleeding or some spotting from the patient as well.
Some interventions that we're going to talk about. We want to get a full gynecological history from the patient. So with this, you're going to want to see about their previous pregnancies, any difficult births that the patient may have had, any sort of gynecological treatments that the patients had, any abnormal pap smears and any other sort of history that might help determine the risk for this patient. We want to assess for a vaginal discharge. So you want to make sure that you're noting the volume and you are noting the color and the consistency of the discharge. Patients often report a change in the vaginal discharge, usually from a clear color to like a white, or a pink color, maybe even tan. There might be an increase in discharge or vaginal bleeding. You want to get a history of substance abuse; patients typically are on medications or substances that may cause premature dilation of the cervix. Some other interventions that we want to think about with these patients, we want to make sure we're encouraging them to decrease physical activity and avoid any exercise or intercourse and to take frequent breaks, because ,unfortunately, any sort of continued pressure that is put on the cervix can cause premature dilation, thus increasing the risk of preterm labor. We also want to administer any sort of medications when it's appropriate, such as tocolytics or steroids as they are going to help stop preterm labor and also help the baby's lungs mature faster. Also analgesics as they may be complaining of any sort of pain, especially after having a procedure if needed. They may do an amniocentesis, which may be required to determine if a patient's eligible for the cerclage procedure. When they have a cerclage placement, it's going to help keep that cervix closed. They will have stitches that are placed by the physician and it will help prevent any sort of preterm labor. And usually they’ll be taken out the third trimester before birth. Other things you want to consider are nutrition and lifestyle education. You want to make sure the mom's maintaining a healthy weight gain during pregnancy and avoid any sort of smoking or drinking alcohol.
So some key points that we want to be sure we're going over patho and etiology of an incompetent cervix. Cervical insufficiency is the premature thinning and dilation of the tubular end of the uterus or cervix damage to the cervix either through surgery, dilation and curettage or previous difficult burst may result in an incompetent cervix. Subjective and objective data. So what are we going to see with these patients? They're going to have pelvic pressure, abdominal cramping, backache, changes in vaginal discharge, and light vaginal discharge. Making sure you note the volume, color, and consistency. You want to decrease activity and give medication. So encourage decreased activity, avoiding exercise, and intercourse, taking frequent breaks. You may be giving tocolytics that will help with preterm labor and steroids with the preterm labor for lung maturity. Cerclage placement prevents preterm labor. You want to make sure you're educating the patient to maintain healthy weight gain during pregnancy and also avoid smoking and drinking alcohol.
You guys are doing wonderful. Thank you so much. We love you guys. Go out, be your best self and as always happy nursing.
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