Vital Signs, Tears, and Varney's 4th Stage Flashcards
What are the normal vital signs for mom?
Temperature: 96-99.0F
BP: 90/50 - 140/90 during labor, prenatally should not be more than 130/90
Pulse: 60-80; during labor: 60-100bpm
Respirations: 12-20
Temp may be elevated up to 101.0 with an epidural
What are the normal vital signs for baby?
Temperature: 97-100.00F
Pulse: 120-160, can go down as low as 100 when resting
Respirations: 30-60
What are the vital sign warning signs during labor?
- Baby’s heartbeat is less then 100 or great than 180 and does not change with oxygen, fetal scalp massage, or fluids.
- BP goes past 140/90 and mom has protein in urine (preeclampsia)
- BP drops 15 points or more in the bottom number (Bleeding/placenta separation)–sign of shock
What are the vital signs of dehydration?
Low grade fever (up to 100.4)
Fast deep breathing (more than 20 reap/min
Fast weak pulse (more than 100 bpm)
Baby’s heartbeat is elevated during labor (greater than 160bpm)
What are the vital signs of shock?
Fast but weak, threat pulse (Greater than 100bpm) Lower blood pressure (less than 90/50 or BP drops 15 points or more in the diastolic number) Increased Respirations (more than 20)
What are the vital signs of infection?
Increase in pulse (+15 bpm over normal baseline pulse)
Increased temp in adult (greater than 100.4)
In Newborns–will see a lowered temp (less than 97)
What are the increased risk for tears?
- Chronic yeast infections
- Red heads (delicate skin)
- Thongs/Tight pants/Non-cotton undies
- Pantyhose (too hot)
- Fear or birth or fear of tearing
- Being in an uncomfortable environment
- Long Labors (lack of oxygen to perineum)
- Large baby
- Post dates (molding doesn’t happen)
- Nuchal hand
- Lithotomy Position
- Over-aggressive coaching during pushing
What are helpful ways to prevent tearing?
- Grapefruit sitting
- Prenatal Perineal massage
- “Tell stories” during labor/vaginal exams to ease the woman’s tension
- Warm compresses and Olive oil to the perineum while the mother is pushing.
- Having a woman reach down and touch her baby when beginning to crown.
- Ease the baby out at crowning. Have the mother slow pushing and pant, blow, or cough the baby out.
What are good Remedies for the Perineum?
- Arnica oil (helps tissue stretch
- Before looking at a tear put lidocaine topically so she will not feel it.
- Don’t put ice packs right after birth–use frozen OB pads
- Sea Salt Sitz Baths
- Super glue first degree tears
What are causes of 3rd and 4th degree tears?
Increase in epidurals, pushing through the crowning sensation, giving birth in the lithotomy position, squealing or high pitch screaming, squatting for too long.
What is the midwife responsible for in the first hour post partum?
- Evaluation of uterine contractility and bleeding.
- Inspection and evaluation of cervix, vagina, and perineum
- inspection and evaluation of the placenta, membranes, and umbilical cord
- Assessment and repair of lacerations or episiotomy
- Evaluation of vital signs and other physiological changes that indicate recovery
What other important activity takes place during the first hour after birth?
The formation of family relationships
What does a uterus found above the umbilicus indicate?
If centrally located, he presence of blood and clots int he uterus that need to be expressed. If displaced, it means the bladder needs to be empty.
How should the uterus feel?
Firm to the touch
What does the midwife need to notice about the placenta?
Identify the different types and cord insertions; be aware of whether the placenta and membranes are complete, and if any abnormalities are present.
