D.

History of previous pregnancies

○ Method of delivery
○ Place of delivery
○ Risk involved complications
E. Prevent Pregnancy / Danger Signs
○ Nausea / vomiting
○ Vaginal bleeding
Intrapartum Assessment ○ Absence of FHT
A. Routine admission care ○ Swelling of face / lower extremities
1. Receive Patient ○ Severe continuous headache
2. Don't allow patient to walk (sop ○ Pallor
wheelchair) if: ○ Sudden escape of fluid (RBOW)
- RBOW Physical Assessment
- LBOW 1. Cephalocaudal assessment
- Severe vaginal bleeding (including mouth and teeth)
- Increase BP 2. Baseline maternal and fetal status
- Preterm labor ○ VS of mother
- Severely in pain ○ Uterine contraction
- With bearing down sensation, etc. ○ Weight
3. Change with DR slippers and ○ FHT movement
change wheelchair (outside 3. Leopold's Maneuver
wheelchair cannot enter to the DR ○ Not indicated to preterm and
room) with severe bleeding
4. Bring patient to receiving area (IE ○ It is a standard palpation of the
room) abdomen for assessing the fetal
5. Change street clothes to hospital position, presentation and
gown (in lying in there’s no need to degree of decent
change). 4. FHT - fetal back
- Remove underwear and jewelries; ○ Normal range: 120 - 160 bpm
provide privacy. ○ Should not be taken during
- If not contraindicated let patient uterine contraction
void/urinate or offer a bedpan
6. Assist in lithotomy positions in IE Pelvic Examination
table 1. Internal Examination
7. Do perineal - flushing / shave a. Let patient void and explain the
8. If patient is ready - Call the OB procedure
9. Assist in attachment of EFM b. Place on lithotomy position
10. Assist patient to labor room c. Shave halfmoon
d. Perineal flushing
B. History taking / Data gathering e. Call OB resident/OB
○ Demographic Data f. Assist doctor; offer sterile IE
○ Obstetrical Data gloves and serve KY jelly
● GPA g. IE results:
● TPAL ○ Dilatation
C. Medical Data ○ Effacement
○ Hypertension ○ BOW
○ GDM ○ Presentation
○ Labs: ○ Station
● CBC, VA, Blood Type, Rh Factor
 3. Acceleration
= whole hand on fundus - Normal

1. Frequency – beginning of 1st contraction

to beginning of next contraction.
2. Interval - end of the first contraction to
beginning of next contraction.
- measured in minutes
3. Duration – beginning to end of the
same contraction
-measured in seconds
4. Intensity: strength of uterine contraction
a. Mild = lips
b. Moderate = cheeks / nose
c. Strong = forehead 4. Late Deceleration
- Placental Insufficiency
- Onset of deceleration is seen AFTER or
TOWARDS the END of a contraction
● TOCO (tocodynamometer) - measures - Insufficient blood flow from the uterus to
the pressure during contractions. placenta
● Ultrasound - FHT
● Event Marker - fetal movement

1. Variable Deceleration
- Cord Compression
- No pattern/ Irregular movement
- Sudden drop, rapid return

● All objects in the sterile field must be sterile.

● Sterile objects become unsterile when
touched with unsterile objects.
● Sterile items out of vision or below the waist
2. Early Deceleration level of a nurse must be considered
- Head Compression (manganak na) unsterile.
- Onset of deceleration is seen BEFORE ● Edge of sterile field = considered unsterile
or AT the start of contraction
M - edication
E - xercise
T - treatment
H - ygiene
O - utpatient
D - iet