INTRAPARTAL NURSING ASSESSMENT Developed by D. Ann Currie, R.N., M.S.N.

INTRAPARTAL MATERNAL ASSESSMENT REVIEW PRENATAL DATA REVIEW PRENATAL DATA HISTORY AND INTRAPARTAL RISK SCREENING HISTORY AND INTRAPARTAL RISK SCREENING ASSESSMENT OF LABOR ASSESSMENT OF LABOR PHYSICAL ASSESSMENT PHYSICAL ASSESSMENT FETAL ASSESSMENT FETAL ASSESSMENT PSYCHOSOCIAL ASSESSMENT PSYCHOSOCIAL ASSESSMENT

INTRAPARTAL MATERNAL ASSESSMENT CONT. CONT. CULTURAL ASSESSMENT CULTURAL ASSESSMENT LEARNING NEEDS ASSESSMENT LEARNING NEEDS ASSESSMENT LABORATORY AND DX TESTS LABORATORY AND DX TESTS

REVIEW PRENATAL DATA OBTAIN PRENATAL RECORD FROM HEALTH CARE PROVIDER OBTAIN PRENATAL RECORD FROM HEALTH CARE PROVIDER REVIEW PRENATAL RECORD REVIEW PRENATAL RECORD CLARIFY AREAS CLARIFY AREAS COMPLETE MISSING INFORMATION COMPLETE MISSING INFORMATION NO PRENATAL CARE NO PRENATAL CARE

HISTORY AND INTRAPARTAL RISK SCREENING PHYSICAL PHYSICAL PSYCHOSOCIAL PSYCHOSOCIAL CULTURAL CULTURAL PRENATAL CARE PRENATAL CARE

ASSESSMENT OF LABOR CLINCAL MANIFESTATIONS OF LABOR CLINCAL MANIFESTATIONS OF LABOR CONTRACTION ASSESSMENT CONTRACTION ASSESSMENT CERVICAL ASSESSMENT CERVICAL ASSESSMENT FETAL POSITION AND STATION ASSESSMENT FETAL POSITION AND STATION ASSESSMENT MEMBRANE STATUS ASSESSMENT MEMBRANE STATUS ASSESSMENT

CLINICAL MANIFESTATIONS OF LABOR PREMONITORY SIGNS OF LABOR- LIGHTENING,BRAXTON HICKS CONTRACTION,CERVICAL RIPENING,BLOODY SHOW,ROM,BURST OF ENERGY,WT LOSS,BACKACHE,GI PROBLEMS,LEG PAIN PREMONITORY SIGNS OF LABOR- LIGHTENING,BRAXTON HICKS CONTRACTION,CERVICAL RIPENING,BLOODY SHOW,ROM,BURST OF ENERGY,WT LOSS,BACKACHE,GI PROBLEMS,LEG PAIN TRUE VS FALSE LABOR TRUE VS FALSE LABOR

STAGES OF LABOR FIRST STAGE OF LABOR-LATENT PHASE,ACTIVE PHASE,AND TRANSITION PHASE. FIRST STAGE OF LABOR-LATENT PHASE,ACTIVE PHASE,AND TRANSITION PHASE. SECOND STAGE SECOND STAGE THIRD STAGE THIRD STAGE FOURTH STAGE FOURTH STAGE

CONTRACTION ASSESSMENT METHODS METHODS CONTRACTION CHARACTERISTICS CONTRACTION CHARACTERISTICS

METHODS OF CONTRACTION ASSESSMENT PALPATION PALPATION ELECTRONIC-EFM ELECTRONIC-EFM INTERNAL INTERNAL EXTERNAL EXTERNAL

CONTRACTION CHARACTERISTICS FREQUENCY FREQUENCY DURATION DURATION INTENSITY INTENSITY RESTING PERIOD RESTING PERIOD RESTING TONE (TONUS) RESTING TONE (TONUS)

Contractions

CERVICAL ASSESSMENT VAGINAL EXAMINATION VAGINAL EXAMINATION DILATATION DILATATION EFFACEMENT EFFACEMENT

Effacement

Effacement

FETAL POSITION AND STATION LEOPOLD’S MANEUVER LEOPOLD’S MANEUVER VAGINAL EXAMINATION VAGINAL EXAMINATION FETAL POSITION FETAL POSITION FETAL STATION FETAL STATION DX TESTS DX TESTS

Figure 23–7 Leopold’s maneuvers for determining fetal head position, presentation, and lie. NOTE: Many nurses do the fourth maneuver first to identify the part of the fetus in the pelvic inlet. Leopold’s Maneuver

Fetal Station

MEMBRANE STATUS ASSESSMENT FHR FHR COLOR COLOR TIME TIME AMOUNT AMOUNT PH PH METHODS METHODS

PHYSICAL ASSESSMENT HEAD TO TOE ASSESSMENT HEAD TO TOE ASSESSMENT VAGINAL EXAMINATION VAGINAL EXAMINATION VITAL SIGNS VITAL SIGNS PREECLAMPSIA SCREENING PREECLAMPSIA SCREENING

FETAL ASSESSMENT FETAL HEART RATE FETAL HEART RATE METHODS OF ASSESSMENT METHODS OF ASSESSMENT FETAL HEART PATTERN TERMINOLOGY FETAL HEART PATTERN TERMINOLOGY

FETAL HEART RATE TERMINOLOGY BASELINE FETAL HEART RATE BASELINE FETAL HEART RATE BASELINE FETAL HEART VARIABILITY BASELINE FETAL HEART VARIABILITY ACCELERATIONS ACCELERATIONS DECELERATIONS DECELERATIONS

LEARNING NEEDS ASSESSMENT EXPERIENCE EXPERIENCE BIRTHPLAN BIRTHPLAN CHILDBIRTH CLASS/METHOD CHILDBIRTH CLASS/METHOD PAIN MANAGEMENT PAIN MANAGEMENT PROCEDURES AND TESTS PROCEDURES AND TESTS SUPPORT PERSON LEARNING NEEDS SUPPORT PERSON LEARNING NEEDS

LABORATORY AND DX TESTS PRENATAL LABS &DX TESTS PRENATAL LABS &DX TESTS CBC CBC UA UA STI’S-RPR,HIV,HEP B,&GBS STI’S-RPR,HIV,HEP B,&GBS EFM EFM OTHER OTHER