Week 4 Nursing Care Intrapartum Outline PDF

Week 4 Nursing Care Intrapartum - Outline 1. Childbirth Education ​ Relaxation Methods ○​ Dick-Read Childbirth Education focuses on alleviating the fear of childbirth through education and the pain through relaxation and breathing techniques. ○​ Bradley Childbirth...

Week 4 Nursing Care Intrapartum - Outline 1. Childbirth Education ​ Relaxation Methods ○​ Dick-Read Childbirth Education focuses on alleviating the fear of childbirth through education and the pain through relaxation and breathing techniques. ○​ Bradley Childbirth Education teaches abdominal breathing to increase relaxation and emphasizes the avoidance of medications and interventions. ○​ Lamaze Childbirth Education teaches concentration and relaxation to decrease contraction pain. ○​ ​ Education Points ○​ Pregnancy, Labor & Delivery, Postpartum 2. Locations for Birth ​ Home ​ Birthing Center ​ Hospital 3. Triage & Admission ​ Assessments: ○​ Contractions & Tones ○​ GTPAL, EDD, Meds/Allergies, History, Birth Plan, Last Meal ○​ IOL (Induction of Labor) & C-Section Considerations ○​ Cultural & Labor Partner Considerations 4. Triage Assessment ​ Monitoring: ○​ NST, EFM (Q30 during active labor) ○​ Contraction frequency/intensity ○​ VS (Q1 hour), Temp (Q4 hours) ​ Lab Tests: UA, CBC, RH ​ Sterile Vaginal Exam (SVE): Dilation, Effacement, Station ​ Amniotic Fluid Assessment: ○​ TACO (Time, Amount, Color, Odor) ○​ SROM Testing (Ferning, Nitrazine paper) 5. Common Labor Terms ​ AROM, SROM, Cephalic, Station, Lightening, Dilation, PROM ​ NST, Engagement, SVE, Fundus, EFM, FHR, Effacement 6. Fetal Monitoring ​ Monitor Placement: Leopold’s Maneuvers ​ Baseline Variability: ○​ Absent: No change ○​ Minimal: 25 bpm - fetal hypoxia is present ​ Accelerations: 15x15 Rule ​ Decelerations: ○​ Early ○​ Variable (15x15) ○​ Late ○​ Prolonged - more than 2 mins ​ Internal Monitoring: Scalp Electrode, IUPC 7. Labor Categories ​ Category I: Normal (Baseline, Accels, No variables/lates) ​ Category II & III: ○​ Bradycardia, Absent Variability, Recurrent Late or Variable Decels, Sinusoidal This refers to the Fetal Heart Rate (FHR) Category System used to interpret electronic fetal monitoring (EFM) during labor. It helps determine if a baby is well-oxygenated or if there’s potential distress. 📊 Category I – Normal (Reassuring Pattern): ​ Baseline: 110–160 bpm (normal range). ​ Variability: Moderate (6–25 bpm changes). ​ Accelerations: Present or absent (both are okay if other signs are normal). ​ Decelerations: ○​ No late or variable decelerations (bad signs). ○​ Early decelerations are okay (usually from head compression during ✅ contractions). ​ Meaning: Baby is well-oxygenated; continue routine monitoring.  ⚠️ Category II – Indeterminate (Watch Closely): ​ Could include: ○​ Bradycardia (FHR 160 bpm). ○​ Minimal or marked variability. ○​ Absent accelerations after fetal stimulation. ❗ ○​ Variable or late decelerations that are occasional or not repetitive. ​ Meaning: Not clearly normal or abnormal. Requires closer observation and possibly interventions to improve fetal status (e.g., repositioning mom, oxygen, IV fluids). 🚨 Category III – Abnormal (Non-Reassuring, Emergency): ​ Critical signs include: ○​ Bradycardia with absent variability. ○​ Absent variability with recurrent late decelerations or variable decelerations. ○​ Sinusoidal pattern: A smooth, wavelike, undulating pattern (rare but serious—can indicate severe fetal anemia or hypoxia). ​ Interventions Needed: ○​ Immediate action to correct the issue (e.g., maternal position changes, oxygen, stopping Pitocin). ○​ Prepare for emergency delivery (C-section) if no improvement. Key Terms to Remember: ​ Bradycardia: FHR