LABOR AND AND
DELIVERY
KNOWLEDGE
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SKILLS CHECKLIST scalp electrodes for monitoring 8. Assi Assist st w/ feta fetall scal scalp p bloo blood d sampling
NAME: ID #: DATE: This Skills Checklist is for use by nurses with with more more th than an one one year year exper experie ienc nce e in their discipline discipline and special specialty. ty. Please Please be accurate with your assessment. DESCRIPTION 1 2 3 4 MEDICATION ADMINISTRATION 1.
Interactions, Interactions, incompatibilities, incompatibilities, and side
effects
2. Administer IM, SC medications 3. Monitor IV Drips Oxytocin in induct induction ion,, a. Oxytoc augmentation b. Magnesium sulfate therapy (& other anti-convulsants anti-convulsants for preeclampsia) c. Labor suppress suppressants ants (e.g. Ritrodrine)
d. Antibiotics e. Heparin
IV THERAPY 1. Start IV lines 2. Regulate IVs 3. Mix IV infusion using additives 4. Discontinue peripheral IVs 5. Use IV infusion pumps 6. Use heparin locks 7. Insti Institut tute e and monit monitor or blood/ blood/blo blood od products
8. Draw blood for lab studies
ASEPTIC TECHNIQUE RELATIVE TO L & D 1. Set up a delivery table 2. Set Set up a cesa cesare rean an sect sectio ion n table 3. Circulate for cesarean section 4. Scrub for a cesarean section 5. Circulat Circulate, e, scrub scrub for a post partum tubal ligation
6. Assist with an Artificial Rupture of Membranes 7. Assist with placement of fetal
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9. Inse Insert rt a stra straig ight ht or Fole Foley y catheter 10. Perfor Perform m a vagin vaginal al exam exam & assess assess effacement, dilatation, dilatation, station, presentation
DIRECTIONS: Please indicate your level of experience by placing a check (√) in the box. Experience level: 1 NO EXPERIENCE 2 MINIMAL EXPERIENCE-requires supervision/assistance
3 MODER ODERAT ATEL ELY Y EXPE EXPERI RIEN ENCE CEDD-rrequ equires ires initial review, then performs independently 4 VERY ERY EXPE EXPERI RIEN ENCE CEDD- proficient DESCRIPTION 1 2 3 4 PROVIDE INTRAPARTUM CARE TO PATIENT WITH 1. Pregnancy – hypertension 2. Preeclampsia 3. Eclampsia (seizures) 4. Placenta previa 5. Abruptio placenta 6. Multiple gestation 7. Malpresentations Malpresentations 8. Premature labor 9. Diabetes mellitus 10. Cardiac disease 11. Asthma 12. Infectious diseases 13. Hemorrhage 14. Pyelonephritis 15. Cystitis 16. Sickle Cell Disease 17. Rh incompatibilities incompatibilities
induced
OBSTETRIC TECHNIQUES AND PROCEDURES 1. Stress test (oxytocin challenge test) 2. Con Conduc duct Feta Fetall Activi tivity ty
LABOR AND AND SKILLS CHECKLIST Determinants 3. Perform cardiopulmonary resuscitation a. Infant (assist intubation) b. Infant Infant (umbil (umbilica icall arter artery y catheter) c. Infant Infant (mix resuscit resuscitatio ation n drugs) d. Infant (administer IM narcan) 4. Assess & document progression progression of labor a. Contraction characteristics b. Chan Change ges s in beha behavi vior or,, appearance c. Status of membranes d. Assess and document fetal status e. Determine fetal position
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DELIVERY
KNOWLEDGE
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LABOR AND AND
DELIVERY
KNOWLEDGE
&
SKILLS CHECKLIST breathing and relaxation technique
Name:
DESCRIPTION 1 2 3 4 OBSTETRIC TECHNIQUES AND PROCEDURES (CONT) f. Auscultate FHR (fetal heart rate) using: (1) Fetoscope (2) Doptone Doptone (Doppler (Doppler Ultrasound) 5. Monitor uterine activity & FHR patterns using fetal monitors: a. External monitor (tocotransducer, ultrasound, phono or abdominal ECG transducer) b. Internal monitor (including connecting the leads and calibrating machine)
c. Identify FHR patterns (1) Variability reactivity (2) Decelerations- early, late, variable (3) (3) Tach Tachyc ycar ardi dia a – Brachycardia 6. Assess & document maternal status: a. Vit Vital al sig signs ns (BP, (BP, P) accord according ing to stage of labor and patient stability b. Deviat Deviation ions s from from the norm norm (edema, deep reflexes, clonus) 7. Assess and document maternal status: a. Intake Intake and and outp output ut incl includi uding ng testing urine for glucose, protein, specific gravity, ketones 8. Escort patient to assist with: a. Pelvimetry b. Ultr Ultras asou ound nd scan scan
INTERVENTIONS DURING LABOR 1. Prov Provid ide e phys physic ical al comf comfor ortt measures 2. Provide emotional support 3. Support, guide labor coach 4. Change woman’s position 5. Do a perineal prep psychoprophylactic 6. Coach in psychoprophylactic
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INTERVENTIONS DURING DELIVERY 1. Spontaneous vaginal delivery 2. Provide Provide care and monitor monitor after after rupture of membrane membranes s (spontan (spontaneous eous or artificial)
3. Cesarean section 4. Labor room delivery
ID #:
DESCRIPTION
1 2 3 4
5. Obst Obstet etri ric c anes anesth thes esia ia – moni monito torr thos those e requiring: a. Special surveillance surveillance b. General anesthesia c. Regional anesthesia d. Epidural e. Spinal f. Local infiltration infiltration
IMMEDIATE CARE OF INFANT POST-BIRTH 1. Assign Apgar scores 2. Physic Physical ally ly examin examine e newbor newborn n (anomalies, respiratory respiratory status)
3. Suction infant 4. Weigh infant Identify fy infant infant using using brace bracelet let,, 5. Identi footprints, and mother’s bands
6. Eye prophylaxis 7. Collect cord blood samples 8. Transfer to newborn nursery
POSTPARTUM ASSESSMENT 1. Fundus consistency 2. Lochia 3. Bladder distension 4. Episiotomy 5. Incision (for Cesarean delivery) 6. Vital signs
POSTPARTUM INTERVENTION 1. Initiate fundal massage 2. Provide perineal care 3. Apply ice to perineum 4. Foster parent-infant bonding
LABOR AND AND
DELIVERY
KNOWLEDGE
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SKILLS CHECKLIST 3. Able Able to commu ommun nicat icate e and inst instru ruct ct patien patientt accord according ing to their their age, age, maturi maturity ty and comprehension ability.
5. Initiate post-anesthesia recovery precautions a. Epidural b. General c. Spinal
A
B
C
D
E
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COMPUTERIZED CHARTING 1. Cerner 2. Eclipsys 3. Epic 4. McKesson 5. Meditech 6. Other:
4. Able Able to prov provid ide e a safe safe envi enviro ronm nmen entt according to the specific needs of various age groups. A
B
C
D
E
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Name:
Plea Please se chec check k th the e boxes boxes belo below w for for each each age group for which you have expertise in providing age-appropriate nursing care. A. Newborn/Neonatal (birth – 30 days) B. Infant (30 days – 1 year) C. Toddler (1 – 3 years) D. Preschool (3 – 5 years) E. School Age Children (5 – 12 years) F. Adolescent (12 – 18 years) G. Young Adults (18 – 39 years) H. Middle Adults (40 – 64 years) I. Older Adults (64 + years)
EXPERIENCE WITH AGE GROUPS: 1. Able to assess age appropriate behavi behavior, or, motor motor skills skills and physio physiolog logica icall norms. A
B
C
D
E
F
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2. Able to adapt care according to normal growth and development. A
B
C
D
E
F
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ID #:
I HAVE CURRENT CERTIFICATIONS FOR: TYPE DATE (MM/DD/YY) ARRHYTHMIA CRITICAL CARE ACLS BLS TNCC NRP PALS NALS CCRN Other Other
The The info informa rmati tion on I have have prov provid ided ed in th this is knowledge and skills checklist it true and accurate to the best of my knowledge. Signature (Written/Electronic)
ID #: 4| Page
EXPIRATION
Date
LABOR AND AND SKILLS CHECKLIST This This skil skills ls check checkli list st has has been been revi review ewed ed and approved by Nicole Bloxham, RN. Signature
Date
(Written/Electronic)
ID #: Plea Please se retu return rn to: to: Nort Northw hwes estt Company, PA ATTN: Records Dept. Fax: (866) 352-4338
Nurs Nurse e
Email:
[email protected] [email protected]
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Staf Staffi fing ng
DELIVERY
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