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Nur 113 Intrapartum Care Skills Notes

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Comprehensive and detailed notes on Intrapartum Care - amniotomy procedure, epidural anesthesia procedure, fetal external electric monitoring procedure, etc for NUR 113. *Essential Study Material!!

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  • October 14, 2024
  • 6
  • 2019/2020
  • Class notes
  • Prof. stephens
  • All classes

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NUR 113: Intrapartum Care Notes

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

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