正常分娩课件

汇报人：xxx20xx-03-15正常分娩ppt课件目录正常分娩概述产前检查与评估正常分娩的临床表现正常分娩的辅助检查与诊断正常分娩的并发症及处理正常分娩的产程观察与护理正常分娩的健康教育与心理支持01正常分娩概述正常分娩是指妊娠满28周及以上，胎儿及附属物从临产开始到全部从母体娩出的过程。定义正常分娩是一个自然的生理过程，需要产妇和胎儿的共同参与和努力。特点定义与特点正常分娩的重要性对母体的好处正常分娩可以减少产后出血、感染等并发症的发生，促进产后恢复。对胎儿的好处正常分娩可以使胎儿逐渐适应外界环境，减少新生儿窒息、肺炎等并发症的发生。对家庭和社会的好处正常分娩有助于家庭和谐、减轻社会负担，提高人口素质。以下附赠各项管理制度英文版（不需要可删）急救药品、器材管理制度:1.Rescuedrugsandequipmentshouldbe"fivefixed"(fixedquantityandvariety,designatedplacement,designatedpersonstorage,regulardisinfectionandsterilization,regularinspectionandmaintenance)and"twotimely"(timelyinspectionandmaintenance,timelyreceiptandsupplementation).Theitemisclearlymarkedandcannotbeusedarbitrarily.2.Thenecessaryrescueequipmentiscomplete,ingoodperformance,andinstandbycondition.3.Therescuedrugsarecomplete,withcleardruglabelsandnodiscoloration,deterioration,expiration,ordamage.Theyshouldbeplacedandusedintheorderofdrugexpirationdates(fromrighttoleft).4.Emergencydrugsanditemsforeachdepartment'srescuevehicleshallbeuniformlyequippedaccordingtorequirements.Specializedemergencydrugsanditemsmustbereviewedandapprovedbythedepartmentdirectortodeterminethetype,quantity,specifications,anddosagetobeequipped.Rescuevehiclesmustbeplacedindesignatedlocationsandmanagedbydesignatedpersonneltoensuresafetyandeaseofuse.5.Afterusingrescuedrugsandequipment,theyshouldbefullyreplenishedwithin24hours.Iftheycannotbereplenishedduetospecialreasons,theyshouldbenotedonthehandoverregistrationformandreportedtotheheadnurseforcoordinationandresolutiontoensuretimelyuseduringpatientrescue.6.Thereisaregistrationbookfortheprovisionofdrugsandequipment.Ensureconsistencybetweenaccountsandmaterials,andhandoverbetweenshifts.7.Managementofsealedrescuevehicles:Beforesealing,theheadnurse(ornurseincharge)andanothernurseshallcountthedrugsandequipmentaccordingtotheregistrationbookofdrugandequipmentequipment,verifytheiraccuracy,andsealthemwithaseal.Twopeopleshallsignandfillinthesealingtime.Nurseschecktheconditionofthesealsoncepershiftandcompletethehandover.Theresponsiblenursescheckonceaweek,andtheheadnurseandresponsiblenursesopenthesealsandinspectthedrugsandequipmentintheambulanceonceamonth,withrecordskept.8.Nonsealedrescuevehiclemanagement:Eachshiftshallcountthedrugsandequipmentaccordingtotheregistrationbookandcompletethehandover.Theresponsiblenurseshallinspectonceaweek,andtheheadnurseshallinspectonceeverytwoweeksandkeeprecords,ensuringthattheaccountsmatchthematerials.护理文书书写制度:

1.Nursingstaffstrictlyfollowthelatestrequirementswhenwritingnursingmedicalrecords.2.Thecontentofnursingrecordsshouldbeobjective,truthful,accurate,timely,complete,andstandardized.3.Allnursingdocumentsshouldbewrittenwithablueblackorcarboninkpen.4.AllnursingdocumentsshouldbewritteninArabicnumeralsfordateandtime,withdatesinyears,months,anddays,usinga24-hoursystem,specifictominutes.5.WritingshoulduseChinese,medicalterminology,andcommonlyusedforeignlanguageabbreviations;Completerecorditems;Thetextisneat,thehandwritingisclear,andthelayoutisclean;Accurateexpression,fluentsentences,simpleandconcise:correctformatandpunctuation,notypos.6.Whenerrorsoccurduringthewritingprocess,doublelinethemonthewrongwords,keeptheoriginalrecordclearanddistinguishable,signthemodifier,indicatethemodificationtime,continuetowritethecorrectcontent,anddonotusescraping,sticking,paintingorothermethodstocoveruporremovetheoriginalhandwriting.Eachpageshouldbemodifiednomorethantwotimes,otherwisetheoriginalrecorderwillpromptlycopyagain(exceptformodificationsmadebysuperiors).7.Nursingrecordswrittenbyinternnurses,probationarynurses,orunregisterednursesshouldbereviewedandsignedbynurseswithlegalprofessionalqualificationsinthismedicalinstitution.8.Furthertrainingnursescanonlywritenursingdocumentsafterbeingrecognizedbythemedicalinstitutionreceivingthetrainingfortheirworkability.9.Superiornursingstaffhavetheresponsibilitytoreviewandmodifythewrittenrecordsofsubordinatenursingstaff.Whenmakingmodifications,reddoublelinesshouldbeusedtomarkerrors,writethemodifiedcontent,signandindicatethemodificationtime.10.Temperaturerecords,medicalorders,patientcarerecords,andsurgicalinventoryrecordsshouldbearchivedontime.123又称宫颈扩张期，指临产开始直至宫口完全扩张（开全）为止。此期产妇出现规律宫缩，宫口逐渐扩张，胎头下降。第一产程又称胎儿娩出期，指从宫口开全到胎儿娩出。此期产妇需要配合宫缩使用腹压，将胎儿娩出。第二产程又称胎盘娩出期，指从胎儿娩出到胎盘娩出。此期产妇需要继续配合宫缩，将胎盘娩出，同时观察产后出血情况。第三产程正常分娩的生理过程02产前检查与评估一般检查血液检查尿液检查超声检查产前检查项目包括身高、体重、血压、宫高、腹围等测量，评估孕妇基本健康状况。检测尿蛋白、尿糖、尿酮体等，评估孕妇泌尿系统及代谢状况。包括血常规、血型、肝肾功能、血糖、血脂等，了解孕妇有无贫血、感染及肝肾功能异常等。通过B超或彩超了解胎儿生长发育情况、羊水量及胎盘位置等。询问病史体格检查实验室检查影像学检查产前评估方法01020304了解孕妇既往病史、家族遗传病史、生育史等，评估孕期风险。包括心肺听诊、腹部触诊等，了解孕妇身体状况及胎儿体位。结合血液、尿液等检查结果，综合评估孕妇及胎儿健康状况。通过超声检查等影像学手段，直观了解胎儿宫内情况。高危因素筛查与处理针对高龄孕妇、既往不良孕产史、慢性疾病等高危因素进行筛查。对筛查出的高危孕妇进行专案管理，制定个性化诊疗方案。加强孕期监护，密切关注孕妇及胎儿状况，及时发现并处理异常情况。针对高危孕妇制定分娩期处理方案，确保母婴安全。高危因素筛查专案管理孕期监护分娩期处理03正常分娩的临床表现孕妇会感到上腹部轻松，呼吸顺畅，胃部受压感减轻。子宫底下降分娩前数周，孕妇会感到腹部一阵阵变硬，伴有轻度坠胀感，这是子宫在收缩。子宫收缩分娩前24-48小时，yin道会流出少量血性粘液，这是见红，是分娩即将开始的一个可靠征兆。见红yin道流出羊水，俗称“破水”，是临产的可靠征兆。破水后，孕妇应立即平卧，防止脐带脱垂，并尽快送往医院。破水先兆临产症状第一产程01又称宫颈扩张期，从临产开始到宫颈口开全。此期孕妇会感到阵发性腹痛，随着宫缩的加强，疼痛逐渐加剧，持续时间也逐渐延长。第二产程02又称胎儿娩出期，从宫颈口开全到胎儿娩出。此期孕妇需在产床上配合宫缩用力，将胎儿娩出。第三产程03又称胎盘娩出期，从胎儿娩出到胎盘娩出。此期一般约5-15分钟，不超过30分钟。胎盘娩出后，整个产程结束。产程分期及特点胎儿娩出后，应立即清理呼吸道，保持呼吸道通畅。同时评估新生儿状况，如阿普加评分等。新生儿处理协助胎盘娩出检查软产道观察产后出血情况新生儿娩出后，需等待胎盘自然剥离或协助胎盘剥离，并检查胎盘胎膜是否完整。检查宫颈、yin道及外阴有无裂伤，如有裂伤应及时缝合。产后2小时内应密切观察产妇出血情况，及时发现并处理产后出血。胎儿娩出后的处理04正常分娩的辅助检查与诊断包括血常规、尿常规、凝血功能、肝肾功能等，以评估产妇的一般健康状况。实验室检查影像学检查胎心监护如B超等，用于了解胎儿的大小、胎位、羊水量以及胎盘位置等。通过胎心监护仪连续监测胎心率，以评估胎儿在宫内的状况。030201辅助检查项目产妇出现规律宫缩、宫颈扩张、胎头下降等正常分娩的临床表现。临床表现产妇的血压、脉搏、呼吸等生命体征平稳，腹部触诊可扪及胎背、肢体等。体格检查实验室检查和影像学检查结果符合正常分娩的诊断标准。辅助检查诊断依据及标准鉴别诊断与难产、胎儿窘迫等异常分娩情况进行鉴别，以及排除其他可能导致分娩异常的疾病。注意事项在诊断过程中，要密切关注产妇和胎儿的状况变化，及时发现并处理异常情况。同时，要尊重产妇的知情权和选择权，充分告知分娩过程中可能出现的风险和并发症，让产妇做出自主决策。鉴别诊断与注意事项05正常分娩的并发症及处理加强产前保健，识别高危因素；积极处理第三产程，控制性牵拉脐带协助胎盘娩出；产后密切观察出血量，及时发现并处理出血。预防措施针对出血原因迅速止血，补充血容量以纠正失血性休克，并防止感染。对于宫缩乏力引起的出血，可按摩子宫、应用宫缩剂；对于软产道裂伤，应及时缝合止血；对于胎盘因素引起的出血，应根据情况采取相应措施。处理方法产后出血的预防与处理产褥感染的防治策略预防措施加强孕期卫生宣教，保持全身及外阴清洁；加强营养，增强体质；妊娠晚期避免盆浴及性交；产后注意休息。治疗方法根据病情选用广谱高效抗生素，进行抗感染治疗；取半卧位以利恶露排出，使炎症局限于盆腔内；会阴部保持清洁干燥，必要时行会阴切开引流术。评估与监护复苏后需密切监护新生儿生命体征，及时发现并处理异常情况。药物治疗如情况严重，可使用肾上腺素等药物治疗。胸外按压如心率仍低于60次/分，则进行胸外按压。初步复苏保暖、摆正体位、清理呼吸道、刺激呼吸。正压通气面罩或气管插管正压通气，给予氧气支持。新生儿窒息的复苏技术06正常分娩的产程观察与护理注意宫缩的频率、持续时间和强度，评估产程的进展。观察宫缩定时听取胎心音，了解胎儿在宫内的情况。监测胎心观察宫颈口扩张和胎先露下降情况，判断产程进展。检查宫颈鼓励产妇进食、休息，保持大小便通畅，进行心理支持。产妇护理第一产程观察与护理要点指导产妇用力在宫缩时指导