Specialties Ob/Gyn
Published Sep 1, 2003
at your cervix
203 Posts
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
44 Posts
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
195 Posts
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
630 Posts
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
20,964 Posts
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
477 Posts
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,
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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
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
4 Posts
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.
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
350 Posts
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 :-)
Haze how in the world do you keep up with all that......seems WAY too complicated to me.......I have enough numbers in my head let alone trying to remember all that......I suppose since I'm a traveler I have a hard enough time remember policy from hospital to hospital.....heck until I started traveling I just assumed everyone did it the same way! HA!
I like smiling's idea......everyone every 4 period......tho, i have to say.....many of the day 2 vag's dont need to be awakened at 4am for vitals....what do you do in that case smiling??
mother/babyRN, RN
3 Articles; 1,587 Posts
I have to say, interestingly enough, that in the last place I worked, which separated labor/delivery from both pp and nursery, we took less vs than we do now in the LRDP setting...
Currently for vag deliveries in the LDRP setting, we do checks q 15 minutes times 4, q 30 times three and q 1 hour times 2....That to me is ludicrous in a normal lady partsl delivery after the first hour if nothing is amiss....Babies are on the same schedule....Csections somewhat more......We do so much more stuff in the current place that in my opinion we more than make up for the supposed lack of intervention we strive for....Good luck!