[at your cervix]

I am trying to revise our policy reguarding how often we do vitals and full assessments on mom's and babies. I would like to know what everyone else is doing. So, how often do you do vitals and full assessments on moms (vag vs C-section vs PPTL) and well babies?

Thanks for your help!!!!!!!!!

[valene]

Mother: in OR after CS: as per anesthesia
in LR after vag del: after delivery, and then every 15
minutes for 1 hour unless unstable (this includes fundal
check, lochia, bp, p, r)
on pp unit after CS: upon adm, in 15 min x 2, then in 30
min. (temp and fundal check only once)

Infant: in OR after CS: just for apgar scores and resus./infant
is taken to nur 5-10 min, then it is t,p,r upon admission,
p,r in 15 min., t,p,r, in another 15 min, p,r, in another 15
min., full vs q 1hr for 4 hours then q 4 hours (this is the
same routine for infant vs in lr after vag del)

[OBNurseShelley]

I will just refer to the post-partum routine.
Vag. once per 12 hour shift, unless ordered differently
c-section - every 8 hours, unless ordered differently
well babies - every 8 hours

another place i worked, 8 hour shifts, assessments and vitals were done every 8 hours on everyone or more frequently if needed

again this is just the post-partum routine

[webbiedebbie]

Our vag deliveries are checked q shift (q 12 hours). Our C-sections are checked q 4 hrs, even up to the time they will be going home! I think we need to change/modify the C-sections.

[SmilingBluEyes]

Csections are recovered as per PAR standards defined by AORN---they include the frequent vitals (q5min) for one hour, q15 x4, etc. and assessment of dermatomes for those recovering from regional anesthesia. On vag, vitals are done q15mx4 and q30 min x2.....dermatomes also assessed if regional anesthesia used.

Babies are recovered with mom and at least 3 sets of vital signs within normal limits must be obtained or baby may be admitted to SCN for observation. Breastfeeding success and bonding are assessed on ongoing basis during and after recovery.

All routine vital signs (after recovery time is over) are done on all moms and babies q4h. Shift assessment q8 (head to toe). We are to chart on babies q2h---even if to say: Appears asleep, pink and eupneic. No distress" or something on that order.

[Sarah, RNBScN]

SmilingBluEyes
Temper-MENTAL Redhead

Registered: Apr 2002
Location: Trying to find Myself. Have you seen me?
Posts: 5627
Post #5

Csections are recovered as per PAR standards defined by AORN---they include the frequent vitals (q5min) for one hour,
----------------------------------------

OMG...how do you staff with that acuity for VS's? Is that in the PACU or is that on the PP unit? Curious...

VS vag. del. 1 hour (q15) then q.shift
CS del. q15 x 1, q1/2 x 1, q4h x 4, q12H or routine

Babes

[Sarah, RNBScN]

SmilingBluEyes
Temper-MENTAL Redhead

Registered: Apr 2002
Location: Trying to find Myself. Have you seen me?
Posts: 5627
Post #5

Csections are recovered as per PAR standards defined by AORN---they include the frequent vitals (q5min) for one hour,



----------------------------------------

OMG...how do you staff with that acuity for VS's? Is that in the PACU or is that on the PP unit? Curious...

VS vag. del. 1 hour (q15) then q.shift
CS del. q15 x 1, q1/2 x 1, q4h x 4, q12H or routine

Babes that are healthy with no complications.
Shift assessment complete head to toe or prn
Weights are done on the nightshift.

Hope this helps.

[~DDee]

If you look at the standards, AWHONN indicates that babies should be assessed every 6 hours if in NB Nursery and at least q 4 hours if in NICU. Obviously this is more if baby indicates but that is the minim. standard.

[SmilingBluEyes]

Since we do our own csections, Sarah, we have no choice BUT to follow PAR/AORN guidelines since we are held to that standard.

[HazeK]

OURS:

Vag delivery: q15" x 4... q30"x 4... q1'x2...q4' x4...qs

CS deliveries: q15" x4...q30"x4...q1'x4...q4 x24 hrs...qid




Since we do our own c/s in L&D,
must agree with others that AORN standards should be followed!

Hugs
Haze :-)