DELIVERY ROOM NURSING RETURN

DEMONSTRATION NOTES

OB PACK

1. Do medical handwashing (Remove jewelries!)

2. Check the date on the OB pack (expiration) and
open check black tape (if autoclaved – if not,
white)
3. Place the OB Pack at the center of the table
4. Open first wrap with hands
 Open with the cuffs
 Open farther side first
5. Open second wrap with pick up forceps 9. Place suction bulb on basin, CB at sterile bowl,
 Open with the cuffs cord clamp near curved forceps, surgical gloves
 Open farther side first and needle
 When getting the forceps, no noise should 10. Do surgical hand scrubbing:
be heard  Nails – 20 with brush
6. Take out the items inside the OB pack and  Fingers, each side & web space – 10 with
arrange it in order (from bottom to top) sponge, downward
 2 towels  Palm – 10 with brush, round
 Bonnet  Back of palm – 10 with brush, round
 Flanelle  Forearm divide by 4 plus 2 inches above
 Towel elbow – 10 per side with sponge, downward
 Leggings  Repeat on other hand
7. Take out metal items from sterile pack. Open 11. Wear surgical gloves and maintain sterility
away from sterile field and do banana peel on 12. Remove injecting needle from syringe and with
each pack. Make sure to drop only. DO NOT the help of the assist, twist the syringe to the
SHAKE the items to prevent dust to fall on the anesthesia (Lidocaine) and aspirate. Place
sterile field. needle back.
8. Arrange the equipment: 13. Put blade in the blade holder using straight
 Allis Forceps forceps
 Syringe 14. Place OS to wrap the ovum forceps
15. Stretch suture needles
 Blade holder
 1/3 cutting needle (skin)
 Blade
 2/3 round needle (tissue)
 Mayo scissors
16. Place round needle at needle holder and insert
 3 forceps (2 straight and 1 curved. Put
cutting needle at OS
curved first)
 Tissue Forceps DELIVERY
 Needle Holder
1. Disinfect vulva using betadine spray
 Placental Curette
2. Put on leggings
 Ovum Forceps
 Open away from the table and away from
the uniform
 Put farther side first
3. Put towel under buttocks
4. Give doctor Allis forceps (if bag of water is not
yet ruptured)
5. Open syringe and offer it to doctor (Anesthesia)
6. Offer scalpel (Episiotomy – skin)
7. Give OS (Ritgen’s – to prevent bleeding by
applying pressure to the perineum)
8. Offer Mayo scissors (To cut off tissue)
9. GET THE BABY OUT
  Pull baby with thumb at the forehead then 3. Place 2 droplights in the working area
two fingers at the neck and shoulders 4. Do medical handwashing then put on alcohol
 Down, up, rotate 5. Prepare equipment:
 Place baby at mother’s abdomen  Hypotray
10. Use OS to clean the baby’s nose and mouth.  2 tuberculin syringes
Clean using flanelle.  Vitamin K (0.1cc for term, 0.05cc for
11. Use suction bulb to suction mouth and nostrils preterm)
(not applicable anymore)  Hepatitis B (0.5cc)
 Crede’s prophylaxis (Terramycin ointment) –
remember to state date of opening. Must be
used for 5 days only
 Alcohol swabs
CORD CARE & EPISIOTOMY
 Waste receptacle
1. Wait for pulsation to stop then place cord clamp  Rectal and Axilla thermometer
1-1.5 inches  Stethoscope
2. Milk cord up to 2 inches then lock using straight  Tape measure
forceps  Flanelle (top)
3. Cut below the cord clamp using mayo scissors  Bonnet
4. Do Brandt Andrews maneuver (coiling of  Sterile baby’s gown
placenta) and Crede’s maneuver (pressure on  Mittens
hypogastric area)  Socks
5. Put placenta in the basin and count for the
 Diaper (bottom)
cotyledons
6. Aspirate vitamin K and hepatits B vaccines in the
 15-20 cotyledons tuberculin syringes. Place under the hypotray by
 Placenta should not have hallowed spaces putting it under cuffed handle.
 Placenta complete! 7. Perform medical handwashing and don working
6. Give doctor placental curette (if incomplete) gloves
7. Give doctor needle holder for episiotomy 8. Prepare jotdown notebook with the following
 Remember to cut the knots (2-3 knots) information
8. Cut thread using mayo scissors just above the  Name of baby
finger  Gender
AFTERCARE  Name of mother
 Time of delivery
1. Do perineal washing  Anthropometric measurements (HC, CC,
 Prepare CB with betadine AC, L, Wt)
 Mons pubis  Vital Signs (T, RR, CR)
 Farther leg then near leg 9. Check ID band of baby
 Far labia majora then near labia majora 10. Place baby on the weighing scale
 Far labia minora then near labia minora 11. Place baby back at the working table and
 Urinary meatus to anus perform a quick head to toe assessment
2. Remove leggings then dry everything using the 12. Take vital signs by using the rectal thermometer
second layer of leggings. Drop on the floor first then check the RR at the same time. Check
3. Put on diaper CR after. Record results at jotdown notebook.
4. With assistance, place mother in supine position 13. Restrain baby using flanelle
5. Wash metal equipment, put sharps and 14. Apply Crede’s prophylaxis at the eyes from inner
infectious items on specific bins. canthus to outer canthus at the lower lash line.
6. Clean floor using mop 15. Get 1 CB with alcohol to disinfect area for IM
7. Removal of sterile gloves injection
 Vitamin K at left vastus lateralis
NEWBORN CARE
 Hepa B at right vastus lateralis
1. Perform medical handwashing 16. Release restraints from upper and lower
2. Clean crib by disinfecting the linens extremities
17. Takes anthropometric measurements
  HC – above forehead
 CC - nipples
 AC – above umbilicus
 L – place at heel and vertex
18. Takes VS again but with the axillary
thermometer
19. Cleanses newborn with towel and comb
20. Removes and changes to new clothing
21. Wrap baby with the flanelle
22. Do aftercare
 Wash equipment soaked in disinfectant for
30 minutes