DUTY/OB NOTES 10.
Right documentations
11. Right to refuse
12. Right principle of care
DRUG COMPUTATIONS:
13. Right prescription
1. Macro drops (15 for adult)
14. Right nurse clinicians
𝑣𝑜𝑙𝑢𝑚𝑒 × 𝑑𝑟𝑜𝑝 𝑓𝑎𝑐𝑡𝑜𝑟
𝑔𝑔𝑡𝑠/𝑚𝑖𝑛 = ℎ𝑜𝑢𝑟𝑠 × 60
INTRAVENOUS CATHETER
2. Micro drops (60 for pediatrics) 1. Gray
𝑣𝑜𝑙𝑢𝑚𝑒 × 60 ● 16G
µ𝑔𝑔𝑡𝑠/𝑚𝑖𝑛 = ℎ𝑜𝑢𝑟𝑠 × 60 ● Not usual; large fluid volume; rapid infusion;
high-risk surgery; requires large vein
5 MOMENTS OF HAND WASHING: 2. Green
1. Before touching the patient ● 18G
2. Before clean aseptic procedure ● For blood transfusion; large vein; transferring
3. After touching the patient patient to community hospital to private
4. After body fluid exposure risk hospital/large hospital
5. After touching the patient surrounding/environment 3. Pink
● 20G
THE RIGHTS OF A FILIPINO PATIENT: ● Most common use on IV catheter
1. Right to approve medical care and humane 4. Blue
treatment ● 22G
2. Right to informed consent ● Small vein
3. Right to privacy and confidentiality 5. Yellow
4. Right to information ● 24G
5. The right to choose health care provider and facility ● Pediatric and elderly patients
6. Right to self-determination 6. Purple
7. Right to religious belief ● 26G
8. Right to medical records ● For newborn babies
9. Right to leave
10. Right to refuse participation in medical research COLOR CODING OF INTRAVENOUS FLUIDS:
11. Right to correspondence and to receive visitors 1. Green – plain NSS
12. Right to express grievances 2. Yellow – D5 NSS
13. Right to informed of his rights and obligations as a 3. Pink – D5 LR
patient 4. Red – D5 Water
5. Dark Blue – plain LR
14 RIGHTS OF DRUG ADMINISTRATION: 6. Violet/Purple – D5 IMB
1. Right drug/medication 7. Orange – D5 NM
2. Right client/patient 8. Light Blue – D5 0. 3𝑁𝑎𝐶𝑙
3. Right route 9. Light Green – D5 NR
4. Right dose
5. Right frequency/time COMMON TERM THAT IS WRITTEN IN THE CHART:
6. Right assessment 1. TPR – temperature, pulse, respiration
7. Right approach 2. CBR – complete bed rest without BRPs (bathroom
8. Right education privileges)
9. Right evaluation 3. RTC – round the clock
1
4. CBC – complete blood count 1. Power – which refers to uterine contractions and
5. UTZ – ultrasound (whole abdomen; IVA) maternal pushing efforts
6. DAT – diet as tolerated 2. Passage – which refers to the maternal pelvis that
7. PTA – prior to admission the baby passes through during labor
8. ROC – room of choice 3. Passenger – which refers to the fetus and placenta
9. ROD – resident on duty 4. Psyche – which refers to the client's psychological
10. NOD – nurse on duty status during
11. MOD – midwife on duty
12. S/P – status pose DELIVERY ROOM INSTRUMENTS:
13. T/C – to consider 1. Primi – one time
14. R/O – rule out a. Scissors
15. MGH – may go home (anytime) b. 2 Kelly forcep
16. HAMA – home against medical advice c. Needle holder
17. DAMA – discharge against medical advice (Ex. lack d. Thumb forcep
of financial status) e. Cord scissor
[Additional]
COLOR OF MEDICATIONS: f. Suture
1. OD – white; 8am g. 5cc syringe
2. BID – blue; 8am and 6pm h. Lidocaine (localized anesthesia)
3. TID – pink; 8am, 1pm, 6pm i. Cord clamp
4. QID – yellow; 8am, 12pm, 4pm, 8pm j. OS 4x4 gauze
5. HS – red; 8pm k. Sterile gloves
6. PRN – green 2. Multi – more than two
7. q8H – white 2. Scissor
8. STAT – white 3. Forcep
4. OS 4x4 gauze
7 MECHANISMS OF LABOR/CARDINAL MOVEMENTS: 5. Cord clamp
1. Engagement
2. Descent PLACENTA:
3. Flexion 1. Fetal side (clean)
4. Extension 2. Maternal side (dirty)
5. Internal Rotation Fetal retention – placenta that remain in the uterus
6. Restitution after the pregnancy of the mother.
7. Expulsion
FOUR SIGNS OF PLACENTAL RETENTIONS:
4 STAGES OF LABOR: 1. Uterus become firm and globular
1. The first stage of labor is the slow opening of your 2. Sudden gush of blood from the vagina
cervix. 3. Umbilical cord lengthen outside the vulva
2. The second stage is the birth of your baby. 4. Uterine fundus rises in the abdomen
3. The third stage is separation and birth of the
placenta. VITAMINS FOR NEWBORN:
4. The fourth stage is the first two hours after birth. 1. Vitamin K – 0.1
2. Hepa B – 0.5
4Ps: 3. IH – 1cc syringe
*IM; Vastus Lateralis
2
● Hypothermia Infection
NEWBORN ASSESSMENT: ● Hypoglycemia
APGAR ● Skin to skin contact in relation to
● 7-10 – supportive care hypoglycemia. There is strong evidence
● 4-6 – moderate care that SSC (skin to skin contact) helps
● <4 – aggressive resuscitation with temperature regulation and
1. Activity – muscle tone brown fat conservation in infants. This
2. Pulse may result in stabilization of blood
3. Grimace – reflex irritability glucose by preventing depletion of
4. Appearance – skin color glycogen stores.
5. Respiration – effort 3. Properly timed cord clamping and cutting
● Clamp and cut the cord after cord pulsations
GENERAL CHARACTERISTICS OF NEWBORN BABIES: have stopped (typically at 1 to 3 minutes)
● Length – 50 cm ● Put ties tightly around the cord at 2 cm using
● Weight – 2,500–3,500 g cord clamp and 5 cm from the newborn's
● Head Circumference (measure above abdomen.
eyebrows) – 35 cm ● Cut between ties with sterile instruments.
● Chest Circumference (measure in the nipple This prevents:
line) – 30-36 cm ● Anemia
● ✓ Protects against brain hemorrhage
EARLY ESSENTIAL INTRAPARTUM AND NEWBORN in premature newborn
CARE, NEWBORN SCREENING, BASIC EMERGENCY 4. Non-separation of baby from mother
OBSTETRIC AND NEWBORN CARE AND ● Time bound: Within 90 minutes of age
COMPREHENSIVE EMERGENCY OBSTETRIC AND ● Continuous non-separation for early
NEWBORN CARE: breastfeeding which protects the infants from
infection.
EEINC – practices are evidenced-based standards for
safe and quality care of birthing mothers and their REMINDERS REGARDING BREASTFEEDING:
newborns, within the 48 hours of Intrapartum period 1. Breast milk best for babies up to 2 years
(labor and delivery) and a week of life for the newborn. 2. Give yellowish, first milk called “colostrum” to
assure protection from infection.
FOUR TIME- BOUND INTERVENTION: 3. Breastfeeding your baby exclusively after birth up to
1. Immediate and thorough drying of the newborn six (6) month
● Immediate drying the baby for 30 second to 1 4. Breastfeeding is the best way of providing the ideal
minute food for healthy growth and development of infants
● Use clean dry cloth to dry the baby by wiping 5. Do not give fluids or food except breast milk for the
first the eyes, face, head, front and back, arms six (6) months of life. Bottled milk, juices, or water may
and legs. cause diarrhea.
2. Early skin to skin contacts between mother and 6. Breastfeed your baby on demand
the newborn 7. At about 6 months give carefully selected mixes of
● Place the newborn prone on the mother's nutritious foods supplements
abdomen or chest skin-to-skin. 8. Frequently sucking produces more milk
● Cover newborns back with a blanket and head
with a bonnet. Place identification. IMPORTANCE OF ROOMING-IN:
This prevents: ● R.A 7600
3
● It facilitate mother and child bonding
SIDE NOTES:
● Permits breastfeeding on demand ● Tube feeding/NGT/0-8
● Allows for closer contact with father and other ● Urine collector bag
family members. ● Endotracheal tube – intubation set
● Cautery
IMPORTANCE OF FEEDING ON DEMAND: ● Suture folder
● Episiorrhaphy
● Helps mother breast to produce more milk
● Episiotomy
● It prevents breast engorgement.
● Dysmenorrhea – painful menstruation
● Amenorrhea – absence of menstruation
KEY POINTS TO GOOD POSITIONING: ● Menorrhagia – heavy menstruation
● Baby’s head and body are in a straight line ● Metrorrhagia – bleeding
● Baby’s face is opposite the nipple and the ● Menopause – cessation of period
breast ● Gynecoid – female pelvis
● Baby’s upper lip or nose is opposite the ● Android – male pelvis
mother’s nipple ● Anthropoid – heart-shaped
● Baby’s is held or supported very close to the ● PCAP – pedia community acquired
mothers body pneumonia
● Baby’s whole body is supported if the mother ○ PCAP A – minimal risk
is in a sitting position, especially if her baby is ○ PCAP B – low risk
newborn ○ PCAP C – moderate risk
● Older baby supporting the neck and shoulders ○ PCAP D – high risk
may be sufficient ● CiDex – solution disinfectant for tools; can
● Mother should be relaxed and comfortable last up to 1 month.
● The fetal side is known as “Shiny Schultz”
KEY POINT TO GOOD ATTACHMENT: because of its smooth, shiny, and almost
● Mouth is widely open translucent appearance. This is the side that
● Tongue is forward in the mouth, and may be the baby was living on and where the
seen over the bottom gum umbilical cord inserts into the uterus.
● Lower lip is turned outwards ● Dirty Duncan is the side attached to the
● Chin is touching the breast uterus, and it's so-named because it's
● More areola is visible above the baby’s mouth rough-looking.
than below it
SIGNS OF GOOD ATTACHMENT:
● Baby’s head and body are in line
● Face is opposite the breast
● Head is slightly extended
● Baby is held close to the mother
● Head, shoulder and bottom are supported
● Mother is comfortable and relaxed
● Mother is sitting cross legged
● Baby is well supported on the mother’s leg
