|
|
|
While waiting for signs of
placental delivery, palpate the uterus for signs of uterine relaxation &
possible bleeding into uterine cavity. Oxytocics such as Pitocin are given to
promote contractions, involution, & ↓ bleeding. Sometimes
Methergine or Hemabate are given. After placenta delivered, physician or
midwife inspect vagina & cervix and make necessary repairs. Episiotomy is
repaired.
|
|
Monitor uterine fundus
firmness; vital signs: BP q 5 – 15 min
(↑ - d/t preeclampsia or oxytocic drugs↓; temp – reflect blood loss); dehydration and
exhaustion; “shivers” ; inspect bloody vaginal discharge.
|
|
|
|
Transfer to PP if:
|
|
VS stable, no bleeding,
undistended bladder, firm fundus, & recovery from anesthesia agents
|
|
|
|
See Figure 17-9 for method
of palpating fundus.
|
|
|
|
Enhancing attachment:
contact during 1st hour important; quiet state – baby will
interact with parents; ideal time to breast feed (Swedish study); darken room
if possible
|
|
|
|
Precipitous delivery:
without physician or midwife;
precipitous labor defined as < 3 hrs, rapid birth
|