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Management and Nursing, Interventions, , + Nutrition counseling, , , , + Fetal evaluation, , + Evaluate woman for signs and symptoms of obstetrical, complications, , + PTL prevention: explain for hospitalization, — Encourage bed rest and hydration., , — Institute fetal monitoring and assist with tocolytic therapy, if, ordered., , + Explain to the woman that mode for delivery depends on, the presentation of the twins, maternal and fetal status,, and gestational age, , Page 52, , Management and nursing interventions contd..., , Intrapartum management, + Establish |.V. access, , — Provide for electronic fetal monitoring for each fetus., , — Double setup is recommended for delivery., Availability of two units of crossmatched whole blood., |.V. access with large bore catheter., Surgical suite immediately available., An obstetrician and assistant experienced in vaginal births of twins., Best choice of anesthesia: epidural., Anesthesia provider capable of administering general anesthesia., Neonatal team for each neonate present at birth for neonatal, resuscitation., = Pitocin induction/augmentation may be required secondary to, , hypotonic labor., , — Postpartum hemorrhage may occur due to uterine atony., , , , + Emotional support. Page 53