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Midwifery Pratical Exam January 2021 > Baseline Observations > Flashcards

Flashcards in Baseline Observations Deck (34)
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1

Define respiration?

According to the skills for midwifery practice respiration is defined by which the body gains oxygen (inspiration) and excretes carbon dioxide (expiration)

2

What is the normal respiratory rate in an adult?

12-20bpm

3

What is the normal respiratory rate in a newborn?

30-60bpm

4

What is the procedure for measuring respiratory rate?

1) Count breaths by observing the chest movement for 60 seconds

2) Record findings. As part of the NMC Code all procedures must be clearly documented, it enables consistency and for us to be able to see any deviations from the norm.

5

Why might you NOT obtain informed consent for measuring respiratory rate?

It makes people aware of their breathing and therefore may affect findings

6

What is the technical term to describe a rapid respiratory rate?

Tachypnoea

(Often is rapid,shallow breathing and can occur in response to metabolic acidosis,exercise, fear and fever

7

What is the technical term used to describe a low respiratory rate?

Bradypnoea

(Respiratory rate of below 8, or more commonly 10 breaths per minute)

8

What factors influences normal respiratory rates?

- Exercise
- Pain (hyperventilating)
- Infection (when infection impairs lung function the lungs work harder to oxygenate the body)
- Fever also increases the body’s oxygen demands
- High altitude

9

Why do we carry out a maternal assessment for respiration?

- It is part of the baseline observations
- Whenever other vital signs are recorded, particularly when completing MEOWS chart
- Admission to hospital
- After recovery from pain relief
- Any signs of altered breathing pattern

10

When would a respiration assessment be carried out on a baby?

- At birth as part of the APGAR score
- Whenever vital signs are being recorded e.g meconium-stained amniotic fluid
- Maternal prolonged rupture of membranes
- Known maternal group B strep, hypothermia
- During resuscitation

11

What is the definition of body temperature?

According to the skills for midwifery practice body temperature is defined as the balance between heat gain and heat loss. Humans are homeothermic and therefore their temperature is maintained at 37 degrees Celsius.

12

What is the normal range for temperature?

36.0-37.5 degrees Celsius.

13

What are the five temperature recording sites?

1) Skin
2) Mouth (under the tongue)
3) Rectal
4) Axillary (armpit)
5) Ear (tympanic membrane)

14

A temperature of 38 degrees and above can indicate what?

Low grade pyrexia (mild infection), an allergy, labour

15

How does the body adapt to heat loss?

-Shivering
-Goose bumps
- Behavioural changes

16

How does the body adapt to heat production?

-Sweating
-Flushed skin
-Behavioural changes

17

When should a temperature assessment be carried out?

According to Nice guidelines temperature assessment is part of the MEOWS assessment, it provides a baseline and should be carried out as part of the assessment or whenever any deviations of the norm are recognised. Nice guidelines state that temperature should be measured at the onset of labour, (4 hourly when in labour) (hourly if in a birthing pool), pre-labour rupture of membranes, before and during transfusion of blood/blood products.

18

What equipment is used to gain a temperature reading?

Choosing the equipment for temperature measurement may depend upon the site chosen and the availability of chosen apparatus. However, as we are practicing in an infectious environment of the COVID pandemic it is safer to use disposable (chemical dot) thermometers which as inserted under the tongue for 1 minute with the temper dots facing downwards in the sublingual pocket.

19

What is the procedure to measure temperature?

As part of the NMC Code it is important that informed consent is given prior to any procedure being carried out.

1) Obtain informed consent
2) Wash hands and don PPE
3) Place the thermometer under the tongue , so the temper dots face downwards in the sublingual pocket
4) Keep the thermometer here for 60 seconds
5) Remove after the 60 seconds
6) Record findings
7) Doff PPE, clean equipment and wash hands

As part of the NMC Code documentation is important, it provides consistency and allows us to detect any deviations from the norm.

20

What is a pulse?

According to the skills for midwifery practice a pulse if defined as a pressure wave which is transmitted through the arterial tree and the rhythmic expansion and recoil of the elastic arteries as the left ventricle ejects blood into the circulation.

21

What are the indications to measure pulse?

-On admission (baseline)
-To monitor well-being
-To monitor deviations
-During labour
-During auscultation
-PN assessment
-Spontaneous rupture of membranes (SROM)

22

What are we measuring when it comes to pulse?

-Rate
-Rhythm
-Volume

23

What does pulse volume mean?

The force in which the heart beats, indicating the amount of blood being pumped through he heart. Can be;

-Strong
-Full/bounding
-Weak

24

What does pulse rhythm mean?

The spacing of heartbeats (regular/normal or irregular/ intermittent)

25

Where are the three main places to take pulse?

-Neck
-Brachial
-Radial

26

How long should you measure a pulse for?

60 seconds

However, according to NICE guidelines you can also measure pulse for 30 seconds and double it, although this can provide inaccurate results such as if a woman has an irregular pulse.

27

What is tachycardia?

Heart rate over 100bpm

28

What is bradycardia?

Heart rate below 60bpm

29

What is a normal pulse rate?

Between 60-100bpm

30

How does maternal BPM change during pregnancy?

According to the skills for midwifery practice it increases 10-20bpm from 7-32 weeks gestation. Lowers slightly during the third trimester but increases during labour.