Vit. K, Vag Hand, and Late components....please explain

cnm in progress · May 20, 2009

these might be dumb questions to some, but will someone please explain? i understand the purpose of an infant receiving vit k, but if a parent refuses how long does it take for an infant to make it's own bacteria in the intestines?

vitamin k production takes a few days. it can be delayed by poor feeding. the intestines of a bottle-fed infant will colonize sooner than a breastfed baby.

vag hand-again i understand the purpose of why this may have to be done, but i'm afraid i will be asked to do this in the or and not quite sure how to go about it. i just don a sterile glove and simply reach under the sterile drape and place my hand in the lady partsl canal and push the infants head up. is there anything specific i need to know about approaching the sterile drape. i'm afraid i might touch something i'm not suppose too.

it doesn't happen very often. but if it does, don't panic. glove up, slip under the drape without touching the field, and do just what you described.

and lastly, when a nurse charts, 'an early with a late component,' what exactly does that mean and what will it look like on the monitor strip?

there is no such thing as "an early with a late component". (nor are there "variables with a late onset" because variables have no relationship to contractions by definition). either it's an early, or it's a late. two different physiological mechanisms there...one's benign and the other is not. what you are witnessing is a nurse who is afraid to call a "late" a "late" because once that term is used she better be intervening, or because she's afraid that a doctor is going to get mad because she charted lates, or because she is unsure of whether it is a late or an early, or (hopefully not) she is incompetent at interpreting efm. if you aren't sure whether it's a late or an early, it's probably better to chart something like "indeterminate decel--early versus late, will continue to monitor" and then attempt to adjust your monitors so that you can tell what they are.

babyktchr, BSN, RN · May 20, 2009

Early with late component. Wow. No such thing. Early is early, late is late. NICHD definitions make this all pretty clear. Even variable with late component has been eliminated. As somenone else posted, I am worried for the person who charted that.

NurseNora, BSN, RN · May 22, 2009

Crawl under the drape head first. You have to be covered while the surgery continues. Loosen the leg strap so you can get her legs apart enough to get your hand in the lady parts. Placing your fingers under the head and elevating toward the pubic bone may make it easier to elevate it toward the mother's head. Be prepared for the wierdest thing you've ever felt as the surgeon's fingers brush yours as he/she delivers the head. Remember to tighten the leg strap again when you're done so the leg doesn't fall.

CMCRN · May 25, 2009

Sometimes you actually have to push pretty hard to break the suction if she has been pushing a long while and the head is really wedged in.