Birthing PPH

Question 1

What is the role of the RN during the birthing process and after?

Answer 1

comfort reassurance
monitor for bleeding and do all normal obs and PV loss.
All your normal care for a post op patient. education and guidance with breastfeeding and bonding

Question 2

What exam is performed on the new born infants?

Answer 2

Assess the Apgar score at one minute
and five minutes post birth.
Document the Apgar scores on the
Neonatal History sheet (MR410).

The Apgar score is used to assess
adaptation to extra uterine life. It
measures heart rate, respiratory effort,
colour, muscle tone and reflex response.
The APGAR scores provide information
on the neonate’s early transition.

Full top to toe assessment

Question 3

What medications are given to the mother and infant?

Answer 3

Oxytocin for the mother.

Vitamine K for the infant.

Question 4

What is the placenta examined for?

Answer 4

overall appearance
3 veins 
missing pieces 
no chunks 
odor

Question 5

First Stage

Answer 5

Latent Phase- between 0cm and 4cm of cervical dilatation- Contractions can be irregular and less intense- often longer than the active phase of labour

Active Phase- occurs from 4cm dilatation- normal progress is now 1cm/ hour- contractions are regular, painful, 3 -4:10 & lasting 60secs- presence of a blood stained, mucous show

Transitional Phase- occurs between 8cm – 10cms

Question 6

Second Stage (Birth of the baby)

Answer 6

Birth of the baby:

• occurs at 10cm, full dilatation
• characterised by a compulsive urge to push

Question 7

Third Stage of Labour

Birth of the placenta

Answer 7

Birth of the placenta

• delayed cord clamping
• active management

Question 8

What are the 4 T’s to consider in the management of a PPH:

Bleeding from the genital tract in excess of 500ml within 24hrs of birth

Answer 8

• tone
• trauma
• thrombin
• tissue

Question 9

Signs of Postpartum Haemorrhage (PPH):

Answer 9

• visible bleeding
• maternal collapse
• pallor
• increasing pulse rate
• falling blood pressure
• altered consciousness
• enlarged uterus

Question 10

Consider potential complications related to each trimester such as Hyperemesis and Gestational Hypertension and how we can treat the mother

Answer 10

Hyperemesis = to determine amount and frequency of N&V and that some women may require hospitalization for around the 24hr mark to monitor intake, output, blood chemistry, and IV fluids and electrolytes.

Gestational Hypertension: if it’s 20 weeks gestation with new onset of elevated BP. Should return to normal around 3 months postpartum. If it persists longer than 3 months it will be classified as chronic hypertension. But what is the treatment? Only treatment I could find is for preeclampsia. And that is more severe hypertension during gestation.

Question 11

What are the principles of family centered care?

Answer 11

.

Question 12

what is the normal newborn heart rate?

what is the normal newborn respiratory rate?

Answer 12

RR: Normal rate 30-60bpm
HR: normal 120-160bpm
T: Normal 36.5 - 37.4°C

Question 13

what is the medication given in the third stage of labour?

Answer 13

.

Question 14

What ratio of chest compressions to breaths do you administer in paediatric life support

Answer 14

CPR 15:2

Question 15

What is hyperemesis Gravidarum?

Answer 15

persistent severe vomiting leading to weight loss and dehydration, as a condition occurring during pregnancy.

Question 16

What pain scale would you use in:

• 0-23mths
• 2-7years
• 4-12yrs?

Answer 16

CHIPPS
FLACC,
Face pain assessment

Question 17

What does APGAR stand for?

Answer 17

Appearance
Pulse
Grimace
Activity
Respiration