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7 Cards in this Set
- Front
- Back
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specific info
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A. HX of pregnancy: due date, bleeding, swelling of face or extremities, prior problems with pregnancy
B. Current problems, if pain: where, regular, timing, ruptured membranes, urge to push? C. medical HX: meds, medical problems, PT age, # of prior pregancies, allergies |
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physical findings (objective info)
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A. Vital Signs
B. swelling of face or extremities C. contraction AND relaxation of uterus. Time interval from beginning of one contraction until beginning of second D. Maintain privacy and examine perineum for -vaginal bleeding or fluid: color? -crowning (check during contraction) -abnormal presentation (foot, arm, cord) |
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treatment
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A. ABCs
B. transport on L side C. if vaginal bleeding or in active labor -O2 -start IV, usually 150-200cc/hr D. transport immediately -previous c-section -multiple births -abnormal presenting parts -excessive bleeding -shoulder dystocia -prolapsed cord E. in a routine labor transport immediately unless presenting part is visible be prepared to stop if presents |
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if delivering
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1. use clean technique (gloves, goggles, mask)
2. guide & control, if nuccal cord, tell mom to pant while you position the cord, if too tight double clamp and cut 3. if time suction mouth and nose after head delivered, have mom pant if green tinged 4. anterior shoulder then posterior 5. protect infant from fall and temperature loss, clear and suction airway, keep infant level with perineum until cord clamped 6. ventilate if HR < 100, CPR if <60 7. consider pitossin MD order 10-20units added to 1000ml NS or uterine massage AFTER PLACENTA not before |
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prolapsed cord
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put mother in knee chest position
insert glove into vagina and push presenting part off cord, check cord for pulsations |
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breech births
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if unable to deliver baby's head palce gloved head into the vagina for a V around the baby's mouth and a nose notify hospital and call MD
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shoulder dystocia
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have mother lie flat on back and pull knees up to chest
if no dlivery, apply suprapubic pressure and consult with MD about further maneuvers |
