What is the APGAR at 1 minute? What are your priority nursing interventions? 1. 2. 3. At 5 minutes she continues to have blue extremities, the HR is now over 100, her arms and legs are flexed, her tone is good, and she now has a good cry. What is the 5-minute APGAR score?
Alice, a 42-year-old woman, gave birth to a baby girl at 10:02 pm. She was in labor for about 12 hours. She had an epidural placed at 6:40 pm. She was 10 cm dilated and 100% effaced at 9 pm and started pushing around 9:30 pm. The provided was called and within minutes of the doctor's arrival the baby was born. The baby girl was born at 10:12 pm after about 50 minutes of pushing.
For your one-minute assessment: the infant has blue extremities,
a HR 90, her arms and legs are flexed, her tone is poor, and she is not crying.
Alice becomes very anxious and wants to know why the baby is not crying.
What is the APGAR at 1 minute?
What are your priority nursing interventions?
1.
2.
3.
At 5 minutes she continues to have blue extremities, the HR is now over 100, her arms and legs
are flexed, her tone is good, and she now has a good cry.
What is the 5-minute APGAR score?
While you are completing your assessment of the infant Alice delivers the placenta.
It is delivered 15 minutes after the baby is born.
What do you need to look for when observing the placenta?
For the next 2 hours what are your top priorities?
Mom:
1.
2.
3.
BABY:
1.
2.
3.
What if any medications do you need to give baby?
1.
2.
3.
Alice and the baby are doing fine so you tell Alice that you are going to let her rest for a few minutes and be back in 15 minutes to complete your next assessment.
Upon entering Alice's room to complete your next postpartum assessment, this is what you find.
What assessment findings would you expect to see with this amount of bleeding from Alice?
1.
2.
3.
What are your priority nursing interventions before calling the provider?
1.
2.
3.
You are unable to control the bleeding, so you call the doctor. What orders would you expect the doctor to give you?
1.
2.
3.
It is now three hours after delivery and you now have Alice's bleeding under control. Her fundus is firm and 2 cm above the umbilicus. The provider has written the order for her to be transferred to the post-partum floor.
SBAR for the admitting nurse on the post-partum floor. Be sure to include the pertinent information about mom and the baby and what you would also write in your end of shift nurse's note.
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