Nursing Care During Labor and Delivery

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Category: Education
     
 

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INTRAPARTAL NURSING ASSESSMENT : 

INTRAPARTAL NURSING ASSESSMENT

Maternal Assessment : 

Maternal Assessment 1. History General health Medications Allergies Obstetrical Labor Birth plan

Risk Assessment : 

Risk Assessment Bleeding Rom Hospitalizations Preterm labor PIH Diabetes Abnormal presentation

Physical Assessment : 

Physical Assessment Admission Assessment Labor status Contraction pattern Cervical dilation and effacement Fetal descent Membranes Fetal status laboratory

Fetal Assessment : 

Fetal Assessment Assess fetal position Inspection Palpation: Leopold’s maneuvers Vaginal exam and ultrasound

Fetal Heart Rate : 

Fetal Heart Rate Tools Fetoscope Doppler EFM External or internal Baseline rate: 120 to 160 Abnormal Fetal Heart Rates Tachycardia: sustained rate of 161 or above Marked: 180 or above Causes Early Hypoxia Maternal Fever Dehydration Drugs Amniotitis Hyperthyroidism Fetal anemia

Fetal Bradycardia : 

Fetal Bradycardia Rate Less than 120 during a 10 minute period or longer Causes: Late or severe fetal hypoxia Maternal Hypotension Prolonged umbilical cord compression Fetal arrhythmia

Variability: : 

Variability: Short Term Long – Term Absent decreased Average Increased Marked

Decelerations : 

Decelerations Early Late Variable

Non-Reassuring Patterns : 

Non-Reassuring Patterns Severe variable decelerations or FHR drops below 70 for longer than 30 to 45 seconds Late decelerations of any magnitude Absence of variability Prolonged decels that lasts 60-90 seconds or more Severe marked bradycardia of 70 or less

Nursing management of Decelerations : 

Nursing management of Decelerations Turn mom to left side Administer O2 by face mask at 7-10 L Discontinue oxytocin Increase IV fluids Assess labor progress by SVE Notify physician Monitor VS and stay with pt.

Slide 12: 

Scalp Stimulation Fetal scalp blood sampling