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14 Cards in this Set
- Front
- Back
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Admission to L&D
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Obtain and review prenatal record
Evaluate emotional status/support Pertinent ROS |
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ROS
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Estimated date of birth (EDB/EDD)
Onset, frequency, duration, intensity of ctx Fetal movement (monitor) Vaginal bleeding/bloody show Membrane status Previous childbirth outcomes (chances of something happening to one baby can happen to another) |
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Admission Assessment
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Clinical evaluation of status
Check vital signs FHR and CTX pattern Coping/support |
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Abdominal Exam
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Fundal Height measurement
Leopold's maneuver's - feel for what is in the pelvis Palpate for contractions - feel for funds Membrane status (no meconium) Dip urine for glucose, protein, ketones |
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Rupture of Membranes
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SROM - spontaneous
AROM - artificial (amniotomy) Note time, color, odor, amount Check FHR and perform VE to check for cord prolapse If there is meconium in fluid, prepare suction for birth |
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Evaluating Labor Status
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Maternal/Fetal well-being
Physiological Psychological |
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Cervical Examination
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Dilation
Effacement Station |
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1st Stage Mgmt/Active Phase
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Check pt every 15-30 min
Document FHR and CTX Q 15-30mins BP Q 1-2 hrs Temp (Q4hrs if membrane is intact, Q1-2hrs if membranes ruptured - risk for infection) Voiding Q2hrs Frequent position changes |
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2nd Stage Management
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FHR Q5 min or btn ctxs
BP Q5-15 min Support and Encourage Position changes/optimize positioning Room preparation (warm) Documentation |
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Perineal Outcomes
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Intact
Laceration Episiotomy |
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Midline Episiotomy (MLE)
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Rip more - can go through rectum (stage 4)
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Mediolateral (RML/LML)
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Have to cut through gluteal muscles - chances of extending to rectum is less - more bleeding
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3rd Stage Management
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Assess bleeding and vital signs Q 15 min
At time of placental birth: Palpate/massage fundus until firm Administer pitocin Document Begin postpartum/postnatal care Cultural considerations |
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IV (Pitocin)
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1000cc with 20 units of pitocin
100-125 cc an hour 2 L/bag |
