Assisting and Handling Delivery ( Return Demonstration)

Summary

In this demonstration, Christine Maytallang explains the proper procedure for assisting in a delivery. She walks through essential steps such as preparing equipment, maintaining sterility, and using instruments like forceps and scissors. The demonstration emphasizes the importance of infection control through proper aseptic techniques. Christine also covers the handling of the baby and umbilical cord, delivering the placenta, and assisting the doctor with suturing. She concludes with post-delivery care, including flushing the site, applying antiseptic, and monitoring the patient for infection.

Takeaways

• 🛠️ Prepare the equipment properly by getting the OB pack, placing it on the sterile table, and ensuring all instruments are ready.
• 🧤 Sterility is key: Use sterile picking forceps to open the inner lining of the packs to maintain sterility.
• 👩‍⚕️ The nursing diagnosis for this procedure is a risk of infection due to improper aseptic technique.
• 🔪 Arrange surgical instruments in order of use: bandage scissors, Kelly forceps, umbilical scissors, needle holders, and tissue forceps.
• 💉 Prepare lidocaine and use the scooping method to cap the syringe safely after drawing the medication.
• 🧼 Perform a surgical hand wash and dry hands with a sterile towel before handling the sterile equipment.
• 👗 Don a surgical gown using the sterile technique and request assistance to tie the back part.
• 👶 During delivery, assist the mother by supporting the perineum and safely handling the baby upon birth.
• ✂️ Clamp and cut the umbilical cord 8-10 inches from the baby’s body, ensuring proper procedure.
• 🩹 Assist in suturing the perineal area, helping the doctor with the needle holder, tissue forceps, and surgical scissors.

Q & A

What is the first step in preparing for assisting a delivery, according to the demonstration?

The first step is to prepare the necessary equipment, such as the OB pack, and check for the completeness of the instruments.

How should the OB pack be opened to maintain sterility?

The outer lining of the OB pack can be opened with bare hands, but the inner lining should be opened using sterile picking forceps to maintain sterility.

What is the primary nursing diagnosis associated with this procedure?

The nursing diagnosis is 'risk for infection related to improper aseptic technique.'

What is the desired outcome for the patient after delivery?

The desired outcome is that the patient will remain free from any infection after the delivery.

What are some of the key instruments used during the delivery procedure?

Key instruments include bandage scissors for cutting the perineal area, Kelly forceps for clamping the umbilical cord, umbilical scissors, needle holders for suturing, tissue forceps with and without teeth for handling the perineal muscle and skin.

How is lidocaine prepared for the procedure?

Lidocaine is drawn into a syringe by the assisting nurse, and the cap is replaced using the 'scooping method' to avoid contamination.

What technique is used to put on gloves while maintaining sterility?

A closed gloving technique is used to put on gloves while maintaining sterility.

How is the perineal support handled during delivery?

The perineal support is folded and placed between the nurse's dominant hand, then used to support the perineum while the other hand supports the baby's head until it is fully delivered.

What method is used to deliver the placenta, and how is it checked?

The placenta is delivered using the Brandt-Andrews maneuver, where the nurse pulls the umbilical cord gently to encourage separation. After delivery, the placenta is checked for completeness, including both the shiny side (Schultz) and the side attached to the mother (Duncan).

What aftercare steps are taken once the placenta is delivered?

After the placenta is delivered, the site is flushed with normal saline and antiseptic (such as betadine) is applied. A diaper is also applied for the patient's comfort, and vital signs are checked to monitor for signs of infection.