MIDTERMS(SKILLS Flashcards
Prevent infection
2. Increase the viability of the area by removing the bloody discharge
3. Promote comfort
PERINEAL PREPARATION (sterile)
PURPOSE
Help prevent infection so that the birth canal is not contaminated
2. Observe ASEPTIC technique
PRINCIPLES
FRONT TO BACK
➔ Anterior to posterior - s.pubis to anal region
➔ Center to periphery - in inguinal region to mid thigh
DIRECTION
helps in management of labor for filipino women w/ normal labor; increases 1
cm/hr
PARTOGRAPH
cervical dilatation, contraction pattern
PROGRESS OF LABOR
pulse, temp, bp, urine voided
MATERNAL WELL-BEING
FHR, color of amniotic fluid
FETAL WELL-BEING:
- Antepartum hemorrhage 5. malpresentation
- Fetal distress 6. Very premature baby
- Previous cs section 7. Severe preeclampsia & eclampsia
- Multiple pregnancy 8. Obvious obstructed labo
CONDITIONS THAT DON’T NEED PARTOGRAPH
- normal
GREEN
passes alert line
YELLOW
abnormal & passes action line
RED -
symbol “X”
2. Start when woman is in ACTIVE LABOR (4 cm or more) and is contracting
adequately (3-4 contractions in 10 minutes)
3. Start plotting on alert line in the intersection corresponding cervical
dilatation finding
4. Perform internal examination every 4 hours, or more often if necessary
Recording the findings in the partograph
If plotting reaches alert line:
consider referral, Alert transport services,
Monitor intensively
If plotting reaches the action line: r
refer to hospital unless birth is imminent
“ I
intact
C ”
clear
M
meconium stained
A
absent
B
BLOODY
If she remains in latent phase for next 8 hours (labor is prolonged),
transfer
her to hospital.
urinates 20x/day; control usually gained b/w 2
and 5 y/o
➢ INFANTS & CHILDREN:
toilet trained
➢ PRESCHOOLERS:
nocturnal enuresis/bedwetting
➢ SCHOOL AGE
nocturnal frequency
ELDERLY:
privacy, normal position, time, sound of
running water
PSYCHOSOCIAL FACTORS:
alcohol, antidiuretics
➢ CAFFEINE FILLED DRINKS are diuretics
➢ FOODS & FLUIDS HIGH IN SODIUM CAUSES FLUIDS TO BE
RETAINED
- FLUIDS AND INTAKE
incomplete emptying of the bladder
ENLARGED PROSTATE GLAND
Diuretics promote urination
➢ Anticholinergic; antispasmodics causes urinary retention
➢ Antidepressant; antipsychotics
➢ Antihistamines, antihypertensives
MEDICATIONS
decreased estrogen
PAST MENOPAUSE
Renal failure, circulatory disease
PATHOLOGIC FACTORS
obstructing ureters
Urinary stones:
obstructs urethra
Hypertrophy of prostate gland:
- polyuria (colic) * polydipsia (excessive thirst) * oliguria (low urine output)
- anuria (absence of urine)
- ALTERED URINE PRODUCTION
dysuria (painful urination) * enuresis * urinary incontinence
* urinary retention (can’t release fluid) * neurologic bladders
- ALTERED URINE ELIMINATION
sterile gloves, CB w/ betadine, lubricant (1-2 in.from tip of
catheter), syringe w/ saline solution, drainage bag
CATHETERIZATION
- introduction of catheter through urethra into bladder to withdraw urine
➢ MATERIALS:
tube made of rubber, plastic, latex, silicon, polyvinyl
chloride; the larger the number, the bigger the catheter; size depend on
age
CATHETER
single lumen tube with small eye opening about 1 ¼ cm from insertion tip
STRAIGHT/ROBINSON/INTERMITTENT
PURPOSES:
Relieve discomfort due to bladder distention/provide gradual decompression of distended bladder 2. Assess amt of residual urine 3. Obtain urine specimen 4. Empty the bladder prior to surgery
children: FR 8-10; black ➔ Young girls: FR 12; white ➔ women: FR 14-16; green; 16- orange ➔ male: FR 16-18; red
SIZE & COLORS ➔ children: FR 8-10; black
LABORATORY EXAMS:
straight
BLADDER EMPTYING
folley or indwelling
PURPOSE:
Manage incontinence (last resort if other measure failed) 2. Provide intermittent bladder drainage/irrigation 3. Prevent from contracting an incision after surgery 4. Facilitate accurate measurement of urine output 5. For critically ill pts whose output needs to be monitored hourly
- rotate the head to an occiput-anterior posterior position
FORCEPS ASSISTED DELIVERY
May develop ecchymosis or edema 2. Caput succedaneum (swelling) or cepal hematoma 3. Transient facial paralysis
NEONATAL RISK
Complete dilatation 2. Ruptured membranes 3. Vertex or face presentation 4. No CPD (cephalocaudal disproportion)
PREREQUISITES
a cap like suction; kept not longer than 25 minutes; monitor FHR every 5 min; side effects: scalp wound & skull fractures
- VACUUM EXTRACTION
pts who has had previous low transverse CS birth; incidence of dehiscence(nagbukas ang tahi): 1%
VAGINAL BIRTH AFTER CESAREAN BIRTH (VBAC)
