Gather materials needed - 1, Assess uterine fundus by palpating contractions - 2, Monitor progress of labor using partograph - 3, Wash hands, wear PPE w/ sterile gloves - 4, Apply lubricant and perform vaginal exam (index & middle finger) - 5, Do perineal prep - 6, proper order: mons pubis to low abdomen, labia majora to both thighs, both side clitoris to anus, middle stroke - a, apply sterile drapes if needed - b, Birth of the Head - 7, episiotomy - a., ritgen's maneuver (pressure on perineum and counterpressure to the fetal head) - b., wipe secretions and suction mouth and nose - c., slip the cord - d., apply gentle traction on head toward the perineum (scissor hand) - e., lift head toward symphysis pubis (scissor hand) - f., pull out the rest of the body then shout "baby out" and place on the mother's abdomen - g., maintain infant in a head-dependent position while suctioning excess secretions - h., Delivery of the placenta - 8., identify signs of placental separation - a), apply controlled traction on umbilical cord then massage fundus when separation is noted - b), inspect the placenta for completeness - c), Assist in episiorrhaphy  - 9., Remove the drapes, do perineal care using sterile water and place adult diaper - 10., Check DR instruments, clean and soak per agency policy - 11., Disinfect DR room and table - 12., Record the procedure done, assessment and data of the client - 13.,

Checklist - Actual Student

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