MANAGEMENT OF CLIENT IN 4TH STAGE OF LABOUR

REQUIREMENTS #

1. Blood Pressure apparatus
2. Thermometer
3. Pulse oximeter
4. Timer with second hand
5. Sanitary pad
6. Sterile gloves

STEPS #

1. Inspect client perineum for tears and suture if any
2. Ensure uterus is well contracted by massaging, expel clot to maintain firmness
3. Give uterotonic drug and call Obstetrician if bleeding persist
4. Clean the perineal area, thighs and apply clean perineal pad
5. Remove the drapes, soiled linen, clean and change client clothing
6. Inform client about successful completion of labour
7. Inform client she will be transferred to a clean and warm bed
8. Let client assume a desired position in bed
9. Observe client for chills and provide warmth
10. Check temperature, pulse, respiration, blood pressure and record (every 15 minutes for the first 1 hour, 30 minutes for the second hour and hourly for the remaining 4 hours)
11. Palpate and measure the symphysio-fundal height (every 15 minutes for the first 1 hour, 30 minutes for the second hour and hourly for the remaining 4 hours)
12. Educate and encourage client to massage uterus intermittently
13. Inspect the perineum for bleeding, swelling and manage as such
14. Encourage client to past urine intermittently or pass urethral catheter if necessary
15. Encourage client to change perineal pad often and maintain hand hygiene before and after
16. Offer a bowl of water, soap and encourage client to perform hand hygiene
17. Enquire client desired meal and serve as such
18. Help fix baby to breast
19. Encourage mobility after an hour rest if indicated
20. Assess the degree, location and intensity of pain and manage appropriate
21. Assess client interaction with her baby
22. Document all findings in Maternal and Child Health Record Book (Manual or Electronic)