DR Nurses Responsibilities

NRG 203
Handle Responsibilities:

Introduced yourself
Position pt. in lithotomy appropriately
Prepare the OB-package/set (3towels, 2 leggings, gowns)
Ready instruments inside the sterile table (include forceps,
medical scissor, needle holder, kidney basin, cord clip, OS, primi-
prepare suture needles)
Don gloves
Apply the leggings to the patient
Put on 1st sterile towel over the abdomen
Apply the modified Ritgen’s Maneuver
Assist in episiotomy (Median or Mediolateral)
Handle responsibilities:
Report baby out, gender, time, initial Apgar score
Initial drying of the baby- dries the baby and stimulate breathing.
Feel for the umbilical cord’s pulsation (3mins.-diminished)
Clamp the umbilical cord using cord clip (1/2 inch from baseline)
and apply forcep-5cms apart
Cut the cord near the clip
Hold the forceps attached to the end of placenta, wait till the
placental separation takes place
Report placenta out, type of delivery
Assist in episiorraphy-offer needle and suture to physician.
After care, apply adult diaper, change pts gown.
Documentation.
Assist Responsibilities:
- Introduced yourself to patient
- Position pt. in lithotomy – may facilitate perineal flushing
- Communicate and instruct patient on breathing techniques
- Initial VS of mother, continue monitoring of FHR, contractions-
duration, frequency, intensity
- After baby is delivered, give Oxytocin IM deltoid muscle
- When placenta is out, check the maternal BP, if stable may give
Methergin IM; if BP elevated may give Carboprost
- Assist to comply with necessary materials needed during the
repair and suturing of physician
- Assist in after care of patient.
 Newborn Care responsibilities:
Introduced yourself to the patient-mother, prepare equipments, don gloves
Continuous drying of the baby- dries properly the baby and stimulate breathing.
Remove the 1st-wet towel and ask for the 2nd towel from handle nurse.
Place the newborn at the chest area of the mother (chest-to-chest)
Cover with the 2nd towel and bonnet.
Does the Crede’s prophylaxis (inner to outer canthus of the NB’s eye)
Inject vitamin K at the Left Vastus lateralis (0.1ml-IM)
Inject Hepa B vaccine (0.5ml-IM) at the right Vastus lateralis
Administer BCG 0.1ml-ID at the Right deltoid(do not use alcohol in cleansing the
site)
Do the Anthropometric measurements (weight, height, head circumference, chest,
and abdomen)
When weighing the NB, place a light towel or a paper lining and put the
bare/undress (prevent conduction heat loss)
Continuous skin to skin contact /UNANG YAKAP for 90 minutes.
Never leave the NB (danger of fall when the mother is asleep)
After care and Documentation