Comprehensive and detailed notes on Intrapartum Care - amniotomy procedure, epidural anesthesia procedure, fetal external electric monitoring procedure, etc for NUR 113.
*Essential Study Material!!
Amniotomy – a procedure that intentionally ruptures the amniotic sac to induce labor
o NOT delegated to UAP but can request the UAP to report pt observations for follow up
o Must review MD’s orders and obtain signed informed consent from pt
o Explain to the pt about the procedure - why it is necessary & how the pt can participate
*Assess fetal heart rate prior to, during, and following amniotomy because rupturing the amniotic
membranes changes the pressure inside the uterus and causes risk of a prolapsed cord
During procedure – IMPORTANT!
o Once the membranes are ruptured and fluid is seen – note the color, amount, odor, and
presence of meconium or blood
amniotic fluid should be clear or slightly cloudy & without any odor
meconium stained or bloody amniotic fluid places the fetus at risk for
complications
foul smelling fluid may indicate an infection
absent, decreased, or increased amounts of amniotic fluid may indicate fetal
stress
o Maternal temperature should be assessed every 2h or more frequently if febrile and/or
ordered
high temp might indicate intrauterine infection (chorioamnionitis)
Post-procedure: Document
, Epidural anesthesia – used to lessen sensation in the lower body by blocking nerve impulses from the
lower spine
o NOT delegated to the UAP but can request the UAP to report pt observations for follow
up
o Must review MD’s order and notify anesthesia personnel & obtain signed informed
consent from pt
o Explain about potential side effects (headache, hypotension)
Inform the pt that they should report the onset of a headache
Inform the pt of frequent blood pressure assessments
o Explain to the pt about the procedure - why it is necessary & how the pt can participate
During procedure – IMPORTANT!
o Obtain maternal baseline VS, fetal heart rate, and variability
o Administer an IV fluid bolus per facility policy before the epidural is begun to avoid
hypotension
o Assist and support the woman in position = side-lying with knees flexed or sitting up on
side of bed with back flexed
o BP, HR, and fetal HR are assessed before the test dose, every 5 min during the test dose
and at the end of the test dose
o Have ephedrine at bedside in case of hypotensive or fetal bradycardia episode
o Assess the bladder for distention every 30 min because a full bladder can slow the
descent of the fetus and risk damage to the bladder
o Change positions at least every hour to maximize uteroplacental blood flow, increase
circulation, promote comfort, and avoid a one-sided block
Post-procedure: Document
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller anyiamgeorge19. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $11.99. You're not tied to anything after your purchase.
