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BASIC KNOWLEDGE
VITAL SIGNS NB/PEDIA Temperature(axillary): 36.5 – 37.5C (97.7 to 98.9 F)
IVF COMPUTATION
Temperature(axillary): 36.5 – 37.5C (97.7 to 98.9 F)
 Pyrexia-body temp above normal range TIME = TOTAL VOLUME X DROP FACTOR
(hyperthermia) FLOWRATE X 60MIN/HR
 Hyperpyrexia- very high fever, 41°C and above
 Hypothermia- subnormal temp FLOWRATE = TOTAL VOLUME X DROP FACTOR
HR: 120-160 bpm, 180 bpm crying / 100 bpm sleep TIME X 60MIN/HR
 1 year: 80-140 bpm
 2 yr.: 80-130 bpm NOTE: IF DROP FACTOR IS MISSING OR NOT GIVEN,
 6y. o: 75-120 bpm AUTOMATICALLY USE 15gtts. /min
 10 yr.: 60-90 bpm
RR: 30-60 cpm (Nb-6mos) Shortcut way of Solving:
: Irregular pattern Macro set and Blood set only
: Abdominal breathers Gtts Magic Number
 6-12mos: 24-30 cpm 10 x 6 = 60
 1-5 yrs: 20-30 cpm 15 x 4 = 60
 6-12yrs: 12-20 cpm 20 x 3 = 60
BP: NOT DONE routinely 30 x 2 = 60
60/80, 40/50 mmHg  Multiply the magic number by the given FLOWRATE
O2 Saturation: Normal: 95-100% or TIME, then divide the product by the TOTAL
VOLUME
VITAL SIGNS ADULT EXAMPLE:
MACROSET: 500ml (TV) 20gtts/ml(FR)
Temperature(axillary): 36.5 – 37.5C (97.7 to 98.9 F) MN X FR =
HR: 60-100 bpm 3 x 20gtts/ml = 60
 Tachycardia- pulse rate above 100 bpm TV/60
 Bradycardia- pulse rate below 60 bpm 500ml/60 = 8.333 or 8 hrs time consumed
 Irregular- uneven time interval between beats FLOWRATE:
RR:12 and up: 12-20cpm MN x TIME Consumed
3 x 8 = 24
BP: Adult: 90/60 mmHg, 132/85 mmHg
TV/24
Elderly: 140/70 mmHg, 160/90 mmHg 500ml/24 = 20.833 or 20-21 gtts/ml
O2 Saturation: Normal: 95-100%
MICROSET/VOLUMETRIC CHAMBER
SIGNS OF RESPIRATORY DISTRESS
TOTAL VOL(ml) TOTAL VOL(ml)
- Retractions FR (gtts/min) OR INFUSION TIME (ml/hr)
- Nasal flaring
- Grunting FORMULA METHOD
(FOR VOLUME-RELATED DOSAGE ORDERS)
INFUSION SET
t D
--- x V = A
TYPE DROP FACTOR FR UNIT OF
H
MEASUREMENT
1Ogtts/ml D= desired dose (ex: physician’s orders 120mg)
MACROSET 15gtts/ml gtts/min H= dosage of medication available (ex: the medication is
20gtts/ml supplied as 100mg/5ml)
ugtts/min V= volume of the medication is available in (ex: the
MICROSET 60ugtts/ml cc/hr medication is supplied as 100mg/5ml)
ml/hr A= amount of medication required for administration
BLOODSET 10ugtts/ml gtts/min
ml of solution
ugtts/min
---------------- = ml/hr
VOL. 60ugtts/ml cc/hr
Total hours
CHAMBER ml/hr

JANICE M. GERADILA 1
If the question is given in minutes?
Use this formula;

ml of solution
---------------- x 60 = ml/hr
mins

ml of solution x drop factor

-------------------------------= gtt/min
Time x 60 mins

Practice:
1. 1000ml D5W to infuse over 4 hrs
2. 150ml Cipro 250mcg to infuse over 45 mins
3. 250 normal saline over 5 hours. Drop factor: 10
gtt/mL

IVF
Green- PNSS/ 0.9% NaCl
Dark/royal blue- PLR
Light blue- D5 0.3% NaCl
Pink- D5LR
Red- D5W
Orange- D5 NM TYPES OF DOCTORS ORDER
Violet- D5 IMB 1. PRN Order – As Needed/ Necessary
Yellow- D5 NSS 2. Standing Order- Routine Order
3. Single Order – Continuous
4. Stat Order- Immediately Without Delay
IV cannula color coding
3 MAJOR ROUTE
G26- violet 1. Enteral – Oral, Sublingual, Buccal, Rectal
G24- yellow 2. Parental- Intravenous, Intramuscular
G22- blue 3. Intraosseous, Intra-arterial,
G20- pink 4. Subcutaneous
G18- green 5. Topical- Ophthalmic, Otis(ear), Nasal,
Dermatologic, Urethral

Medication Ticket color coding and CONVERSION

timing CDH FLUID
1mg- 1000mcg
White- OD, single dose, STAT 1g- 1000 mg
Yellow- BID, q12 10z-30 ml
Pink- TID, q6 8 oz.- 1 cup
1tsp- 5 ml
Blue- QID 1 dram- 5ml
Orange- q8 1tbsp- 15ml
Green- q4 1 L- 1000ml
Red- PRN, hs 1 ml- 15 gtts (drops)

1kg-2.2 lbs
1lb- 16 oz

LB-KG (divide by 2.2)

Ex: 120lbs=? kg
120/2.2= 54.545 kg
JANICE M. GERADILA | 2
 - 25-50 mmHg
KG-LB (multiply by 2.2) - Should not exceed 80 mmHg
Ex: 45.6=? lb Resting tone
45.6 kg x 2.2 = 100.32 lb - TENSION in the uterine muscle between
contractions (relaxation of the uterus = fetal
FDAR oxygenation between contractions)
DATE AND TIME - Ave. 10mmHg
Focus – Main problem/ Diagnosis or health teaching - Should not exceed 20mmHg
(ex. Pain, Ineffective breathing)
Data – supporting the focus STAGES OF LABOR
Subjective: ex “maskit aakon ulo”
Objective: ex “Pain scale, Facial grimace, STAGE 1 (CERVICAL DILATATION)
Guarding behavior.
Action – Interventions performed (ex. Encourage Latent (early)
relaxation techniques. Like giving meds)  Longest stage
Response – Evaluation (ex. nag improve sense of  Cervix dilates: 0-3 cms
energy”  Intensity: mild
 Contractions: 15-30 mins
Active
 Cervix dilates: 4-7 cms
 Intensity: moderate
 Contractions: 3-5 mins (30-60 sec in duration)
Transition
 Cervix dilates: 8-10cms
 Intensity: strong
 Contractions: every 2-3 mins (60-90 sec in
duration)

STAGE 2 (Expulsion stage)

 Starts when the cervix is fully dilated and
AFFIX YOUR SIGNATURE OVER YOUR PRINTED effaced
NAME  Ends after the baby is delivered

STAGE 3 (Placental Stage)

Naegele’s Rule  The placenta is expelled (15-30 mins after birth)
- Get LMP (first day of the last mense period) Signs of placental delivery:
- (-3)calendar month, (+) days, (+) 1 year  Lengthening of the cord
 Sudden gush of blood
AOG  Uterus changes from oval to globular shape
- LMP Add # of months till present day of  Visualization of placenta in the vaginal os
consultation then divide by 7 Delivery mechanics:
Shiny “Schultz”
ASSESSMENT OF UTERINE CONTRACTIONS - Side of baby delivered
Duration Dirty “Duncan”
- beginning of the contraction to the end of that - Side of mother delivered 1st
same contraction
- lasts 45-80 seconds STAGE 4 (Maternal Hemostatic Stabilization
- should not exceed 90 seconds Stage)
Frequency - From delivery of placenta to 1-4 hours’ post-
- number of contractions from the beginning of partum
one contraction to the beginning of the next
- 2-5 contractions every 20 mins
- Should not be more FREQUENT then every 2
mins
Intensity
- Strength of a contraction at its PEAK
JANICE M. GERADILA | 3
 UNANG YAKAP  Examined placenta, 2 SIDES
(SCHULTZ – SHINY SIDE FACING TO BABY)
4 core steps (DUNCAN – DIRTY SIDE ATTACHED TO THE
1. immediate and thorough drying UTERUS)
2. early skin-to-skin contact  Flushed PNSS Solution/Sterile water and Perineal
3. properly timed clamping care
4. non-separation of the newborn from the mother  Checked baby’s color/ breathing
for early BF and initiation  Disposed placenta
 Remove the 2nd glove and place it in chlorine
solution 10 mins along the instruments
PREPARING FOR DELIVERY  Advised STSC
 Room temp 25-28 degree Celsius using thermos
stat / eliminated air draft 15-90 MINUTES
 Lithotomy position/semi-upright position  Advise the mother to observe for feeding cues.
 BVM – Bag valve mask(pedia) 30min-1hr after birth. (30 right – 30 left)
 Endotracheal tube (pedia)
 Clean perineum (use clean gloves) ADMINISTER
Clitoris to anus, Labia Minora, Labia Majora,  ERYTHROMYCIN
Clitoris.  VITAMIN K
 Wash hands, Donning and Doffing PPE &  HEP B
Gloving  Put clothes and swaddle the baby and put in
Put 2 pairs of gloves gooseneck lamp to provide warmth.
 Do not perform bathing at least 6hrs of life.
TIME OF DELIVERY  Breastfeeding per demand (6mos.)
 Push as desired  Check baby every 30 mins
 Draped dry linen over the abdomen, prep for  Complete Records
drying the baby
 Support the perineum using the dominant hand AFTER 1HR
 Time of birth & SEX  Vital Signs and check for uterine contractions
 Informed mother every 15mins
AFTER 2HR
FIRST 30 SEC  Vital signs and check uterine contraction
 Put the baby on the abdomen, dry the baby for 30min.-1hr.
atleast 30 sec, quick check breathing/ color. (Do
not remove vernix caseosa
 Do not wash the baby within 6hrs of life to avoid ANTHROPOMETRIC MEASUREMENTS
hypothermia
Head circumference: 33-35cm
1-3 MINUTES Chest circumference: 30-33cm
 Removed wet cloth Abdomen circumference: 30-33 cm
 STSC abd or chest–prone position Length: 45-55 cm
 Put bonnet and 2nd linen cover baby’s back Expected weight: 2500-4000g
 Palpate 2nd baby prep for giving oxytocin and
inject Meds used in the DR
 Remove the 1st gloves for cord clamping (Wait
1-3 mins until cord pulsation stops to prevent VITAMIN K – 1CC
anemia)  Preterm – 0.05ml – 0.5mg
 Clamp the cord using a plastic clamp 2cm from  Full-term – 0.01ml – 1mg
the base, and 5cm instrument clamp and cut  Vastus lateralis site – left upper quadrant
near the plastic clamp. (not midway)  Dart technique
 Wait for strong uterine contraction. Deliver the  developed muscle
placenta (above – below – side – side)  Phylloquinone or Phytomenadione
 Massaged the uterus  Important to prevent blood clot
 Inspect for vulva tears/ laceration
EPISIORRAPHY – TAHI
EPISIOTOMY – CUT
JANICE M. GERADILA | 4
HEP B
 O.5ml
 Given 24hrs after birth
 2nd dose – two months old (after the first dose)
 3rd dose – 6 months & 18 months of age
 Vastus lateralis site – right upper quadrant
 Protection for hep b and serious disease

OXYTOCIN
 1ml (10units)
 Uterus contraction
 Reduce bleeding/ hemorrhage
 IM route
 Deltoid muscle site

ERYTHROMYCIN
 0.5%
 Newborn eye ointment
 Topical and ophthalmic routes
 Inner to outer cantus of the eyes
 Prevent infection
METHERGIN
 to prevent or to treat excessive bleeding after
childbirth
 given after placenta out (not all)
CARBOPROST
 stimulates uterine contractility, resulting in
expulsion of the products of conception
 usually given to patients that has an abortion

APGAR

A – Appearance (Skin color)

P – Pulse (Heart rate)
G – Grimace (Reflex irritability)
A – Activity (Tone)
R – Respiration

SCORE 0 POINT 1 POINT 2 POINTS

A Cyanotic/Pale Acrocyanosis (no
cyanosis)
PINK
P Absent <100 >100
G No response Cry when Cry or pull
stimulated away
A Muscle tone Some Flexed arms
flexion & legs
R Absent Weak, irreg, Strong,
gasping lusty cry

APGAR RESULT
0-3 = severely depressed
4-6 = moderate depressed
7-10 = good/healthy

JANICE M. GERADILA | 5