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