Professional Documents
Culture Documents
Maternal Health Nursing Skills
Maternal Health Nursing Skills
Maternal Health Nursing Skills
Nursing Skills
Mary Lourdes Nacel G. Celeste, RN, MD
RESPONSIBLE
PARENTHOOD
Reproductive
Life Planning
FAMILY PLANNING
Reproductive Life Planning
Includes all decisions an individual or
couple make about having children:
- If and when to have children
- How many children to have
- How children are spaced
- Conception, fertility and counseling
To the mother:
enables the mother to regain her health after the delivery
gives mother enough time and opportunity to love and
provide attention to her husband and children
provides mother who has chronic illness enough time for
treatment and recovery without further exposure to the
physiologic burden of pregnancy
prevents high risk pregnancy
gives mother more time to herself, family and community
? PHILIPPINES
2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26
1
18 DAYS
LONGEST CYCLE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
11 DAYS
UNSAFE TIME
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
UNSAFE TIME
Intramuscular injections
-administered every 12 weeks
Medroxyprogesterone (depo-provera)
-100% effective
Slide your hips down to the edge of the table. Let your
knees spread wide apart, and relax as much as possible.
You can cover your lower abdomen and thighs with the
drape sheet to feel less exposed and more comfortable
during the procedure.
Talking with your clinician about your experience will help your
clinician
tailor the exam to your special needs
help you feel as comfortable as possible
understand how your physical and emotional health may be
affected
Exercise:Tighten stomach
muscles and arch back
toward the ceiling. Hold.
Tighten buttocks, pelvic floor
and back muscles and arch
back to produce hollow. Hold.
5. Walking:
Most highly recommended for the pregnant woman; ideal alternative to more
strenuous exercise. Walk uphill, downhill, and at different speeds.
Typical measurements
- Over the symphysis pubis: 12 wks
- At the umbilicus: 20 wks
- At the xiphoid process: 36 wks
Rises about 1cm per week; after which it
varies
MLNG CELESTE, RN, MD 140
Fundic Height
January 30 days
February 28 Total = 242 days
March 31 AOG = 242
April 30 7
May 31 34 to 35 weeks
June 30
July 31
August 31
MLNG CELESTE, RN, MD 145
Obstetrical History/ Number
G__ P__ (T, P, A, L)
Gravida – the total number of pregnancies regardless of duration
(includes present pregnancy)
Para – number of past pregnancies that have gone beyond the
period of viability (capability of the fetus to survive the outside of
the uterus; currently considered any time after 20-wk gestation),
regardless of the number of fetuses or whether the infant was
born alive or dead
Term infant – an infant born between 38 and 42 weeks of gestation
Preterm – an infant born before 38 weeks
Post term – an infant born after 42 weeks
Abortion – pregnancy that terminates before the period of viability
(20 wks)
Live birth – a live birth is recorded when an infant born shows
sign of life
Slow-Paced Breathing
This technique can be used in early labor and for as long as the
mother is comfortable with it. For some women, this may last
throughout the entire first stage of labor.
1. Take a cleansing breath as soon the contraction begins.
2. Breathe slowly and deeply in through the nose and out through
slightly pursed lips or the nose over the duration of the
contraction.
3. Maintain a steady rate of approximately 6 to 9 breaths during a
60-second contraction (the cleansing breaths do not count).
Purposes:
1. To relieve discomfort due to a bladder distention and to provide
gradual decompression of a distended bladder.
2. To access the amount of residual urine if the bladder is to be emptied
completely
3. To obtain a urine specimen to assess the presence of abnormal
constituents and the characteristic of the urine
4. To empty the bladder completely prior to surgery to prevent inadvertent
injury to adjacent organ such as to the rectum or the vagina
5. To manage incontinence when all other measures have failed
6. To provide for intermittent or continuous bladder drainage and
irrigation
7. To prevent urine from contacting an incision after perineal surgery
8. To facilitate accurate measurement of urinary output for critically ill
client whose output needs to be monitored hourly
Points to consider:
1. There are 2 hazards in the process, namely,
sepsis and trauma, hence asepsis technique
should be maintained and the catheter should be
inserted gently.
2. When catheterization is ordered to relieve bladder
distention, gradual decompression of the bladder
should be done to prevent engorgement of the
vessels as well as improve the muscle tone of the
bladder by adjusting the intravesical pressure
Types of catheter:
1. Straight or Robinson catheter – a single lumen tube with a
small eye or opening about ½ inch from the insertion tip
2. Retention or Foley catheter- contains a second smaller tube
throughout its length on the inside. This tube is connected
to a balloon near the insertion tip. After catheter insertion,
the balloon is inflated to hold the catheter in place within
the bladder.
Catheters are sized by the diameter of the lumen and are
graded on French scale numbers. The larger the number,
the larger the lumen size. Small sizes such as French 8 – 10
are used in children. French 14, 16 and 18 are for adults.
Purposes:
1. To clean the perineum in the following after a bowel or
bladder elimination prior to any vaginal examination or
treatment
2. To prevent vaginal or perineal wound infection and
unpleasant odor.
3. To provide for personal cleanliness and comfort
Special considerations:
Avoid burning the patient by using the right temperature
of the flushing water
Observe special care in order to avoid discomfort when a
patient has a perineal wound or stitches.
Avoid unnecessary exposure.
If the patient defecated, empty the bedpan first before
giving perineal flushing.
Rationale:
a. to provide perineal heat for the comfort of the patient
b. to aid in the healing of the episiotomy or laceration keeping the suture
dry
Nursing objectives:
Avoid burning the patient by prolonged exposure or too-close proximity
to light.
Prevent cross contamination by thorough cleaning of lights between
patients’ use.
Facilitate healing by optimal use of light and heat.
Equipment:
Perineal light
Padding for stirrups
Screen
Sterile perineal pad
Bag for disposal of used perineal pad
Prescribed medication
Procedure:
Explain the procedure to patient. (Importance of the
procedure: It will make her comfortable and promote
healing of the episiotomy).
The patient should empty her bladder prior to the
procedure. A distended bladder may cause discomfort
during the procedure.
Screen the patient.
Position the patient flat on her back in bed. If the bed
has stirrups, they should be padded for comfort.
Plastic and rubber absorb and conduct heat. If a foley
catheter is in place, a clean washcloth should be placed
between it and the thigh, to protect the patient from
being burned by the heated
MLNG tubing.
CELESTE, RN, MD 245
PERILIGHT ADMINISTRATION
Position the perineal light far enough from the perineum to
avoid burning the tender skin; approximately 12 inches is
considered safe. The lamp should not be left on for more
than 20 minutes. Expose the perineum to perineal light
several times a day.
The perineal area must be checked frequently during the
procedure for redness which would indicate that the light
was too hot or the time span was too long. Suture should
be observed for proper healing and signs of infection,
bleeding or any other problems. Observe patient’s
reactions.
A bulb over 60 watts must be used.
Wash the perineal light in a utility room with a germicide.
Cradling BURPING-
ALL INFANTS REQUIRE BURPING
TO EXPEL THE AIR SWALLOWED
WHEN THE INFANT SUCKS
SOME INFANT SWALLOW MORE AIR
THAN OTHERS AND REQUIRE MORE
FREQUENT BURPING
Materials:
Mild soap and water
Clean wash cloth and towel