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NOTES - Module 2 - Admitting A Woman in Active Labor

1. When admitting a woman in labor, providers should conduct an immediate assessment to determine if the labor is progressing normally or if emergency referral is needed. 2. The rapid assessment involves taking vital signs, checking for vaginal bleeding or other complications, assessing fetal well-being including heart rate and movement, and determining status of labor through questions about contractions and membrane status. 3. A focused physical exam then evaluates the abdomen for size and shape, listens to the fetal heart rate, and uses Leopold maneuvers to determine fetal position, lie, and engagement.

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Lorraine Pancho
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40 views2 pages

NOTES - Module 2 - Admitting A Woman in Active Labor

1. When admitting a woman in labor, providers should conduct an immediate assessment to determine if the labor is progressing normally or if emergency referral is needed. 2. The rapid assessment involves taking vital signs, checking for vaginal bleeding or other complications, assessing fetal well-being including heart rate and movement, and determining status of labor through questions about contractions and membrane status. 3. A focused physical exam then evaluates the abdomen for size and shape, listens to the fetal heart rate, and uses Leopold maneuvers to determine fetal position, lie, and engagement.

Uploaded by

Lorraine Pancho
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Module 2: Intrapartal care *If abnormal: refer to CI’s,

resident doctors, midwives, and


Lesson 2: Admitting a Woman in nurses.
Labor c. Check if woman has now / has recently
had
What to consider prior to rapid assessment?  Vaginal bleeding,
- Does she need urgent referral for headache/blurred vision,
emergency care? convulsion, difficulty in breathing,
- Is her labor progressing normally? fever, severe abdominal pain
 Premature leakage of fluid
Conducting an IMMEDIATE/RAPID d. Look at and listen to woman
ASSESSMENT  Is she ambulatory upon arrival?
Equipment / Supplies needed:  Is there blood trickling down her
lower extremities?
 Prenatal record  Is she grunting, moaning, or
 Clean gloves bearing down?
 Doppler and KY jelly !!! If losing blood, she needs
 Digital Thermometer urgent help!
 Watch/Timer with second hand (for
monitoring of FHR and contractions) HISTORY TAKING
 Sphygmomanometer and Stethoscope a. Record socio-demographic data
 Bed pan  Name, age, height, address,
 Wear PPE religion, occupation
b. Write down her chief complaints
STEPS:
c. What is her Labor status?
FOCUSED ASSESSMENT d. History of past and present pregnancy?
 GPTPLAM, LMP, AOG
a. Is it true labor? If so, is birth imminent?
e. Calculate for EDC / EDD
 Aske her to describe the
contractions PHYSICAL EXAMINATION
 Check if her membrane has
a. Inspection of the abdomen
ruptured:
3 S’s
!!! If so, examine amniotic fluid for
 Size – SGA or LGA?
color and odor
- polyhydramnios
 Inquire if there is a decrease in
 Shape – oval shape
fetal movement
 Scar – are there scars due to
!!! Assess fetal well-being (FHR
prev. CS? = this might be a risk
and contractions)
factor. Women might experience
 Is there a change in the woman’s
uterine rupture
health status?
b. Palpation of the Abdomen
b. Check woman’s vital signs
 Leopold Maneuver
 Blood pressure – (N) 90/60
1. Fetal Presentation
mmHg – 120/80 mmHg
2. Fetal Lie
 Maternal pulse rate – (N) 80- 100
3. Fetal engagement
bpm
4. Fetal attitude
 Temperature – (N) 36.5 – 37.4 C
c. Auscultate for FHR (N=120-160 bpm)
 Listen to FHR after contraction /
every 30 minutes
 Every five minutes during second
stage of labor
HOW TO MEASURE UTERINE
CONTRACTIONS
a. Duration: measured from the start of
one contraction to the end of that
contraction
b. Frequency: measured from beginning of
one contraction to the beginning of
another contractions
c. Interval: measured from the end of one
contraction to the beginning of another
d. Intensity:
 Nose = mild
 Chin = moderate
 Forehead = strong

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