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Birth settings
Alternative births settings give the mother more control over the
birthing process
Hospital more controlled setting and better able to deal with the
problems, however multiple rules to follow.
Home birth midwife helps with that. This is less expensive but
involves risks.
Care plans; is a major challenge for the nurse all care plans are
individualized
Physical exam
Monitoring fetal heart rate; should be between 110 and 160 bpm
if less or more the MD should be notified. The best way to
auscultate a fetal heart rate is thru it’s back. Do the leopolds
maneuver first to assess the position of the fetus. When you hear
the heart rate take that mother’s at the same time to see if they
synchronize if they do then you have to take the fetal heart rate
at a different site cause they should be different
The doula
Teaching
Water birth
Expulsion of placenta
• Cord lengthens
• Gush of blood
• Vagina
-Elevation of the fundus
• Risk for hemorrhage in this stage, monitor v/s
• Administer pitocin post delivery of placenta.
• Maintain thermoregulation
• Cardiorespiratory support
• Identification and clamping cord
• Doc urination and passage of meconium ( must be passed
within 24 hr of birth the first temperature on baby is rectal
to check for patency.)
• Perform brief assessment of newborn
• Place baby in radiant warmer
• Aspirate the mouth and nose
• Use blow by O2 if cyanotic
• Stimulate breathing by warming, manual stimulation
suction, or O2 adm bag/mask, rescucitate the infant
• Apgar score at one minute and five minutes.
• Administering vitamin K
• Prophylactic eye care
• Observing for abnormalities
• Umbilical cord blood bank
• Cord clamped is placed on umbilical stump and the stump
for 2 and 1 vein
• Erythromycin in eyes to protect against Chlamydia and
gonorhea
• No MD or NM present
• Common in multipara women
• Sterility is not a priority
• Controlling the birth of the head no 1 priotity
• Will prevent maternal laceration and trauma to the head
• Mother to pant to control descent of head never push head
back
• Check to see where the cord is
• If around gently loosen and lift over
• If cord is tight clam in 2 places and cut
• Suction nose and mouth
• Major interventions stay calm and supportive provide
cleanliness, control birth of infant