PPH prevention
When is postpartum pitocin started?
What is: with the delivery of anterior shoulder.
New mother wants to pump breastmilk and asks how long is breastmilk good for in room temperature?
What is 4 hours.
How often are I/Os documented (patient has a foley catheter) when patient is on MgSu for pre-eclampsia?
Severe blood pressure is defined by
What is >160 SBP and/or >110 DBP
Your patient is actively pushing in second stage of labor. After each push, what is your priority action?
What is assess fetal heart rate/adjust your fetal monitor.
Most common cause of postpartum hemorrhage
What is uterine atony
What is 41 or more.
The initial bolus of amnioinfusion rate/dose
What is 250ml over 20mins.
What is a normal urine output per hour?
What is half of their weight (kg) in ml. For example: 100kg patient = urine 50ml/hr
Your patient has had cat II tracing for the 30 mins. You have been continuously resuscitating your patient. Your next action is to
What is: call for cat II tracing huddle with provider, and charge RN
Upon palpating your patient's fundus, you notice the uterus is deviated to the side. What is your initial nursing action.
What is: empty the bladder
What is the standard suction catheter size that should be set up at every infant warmer prior to delivery?
Patient was on pitocin of 18mU, and the pitocin was stopped at 10:30am. Provider now orders to restart pitocin at 10:50am. You confirm cat I tracing with irregular contractions and start your pitocin at
What is 9mU
You are starting MgSu for a patient with pre eclampsia. How often should you monitor and document vital signs, neuro checks and lungs sounds?
Q15min first hour
Q30min second hour
Q1 hr for duration of magnesium
TOCO notes 6 contractions in a 10-minute window lasting over 30 mins. EFM reports cat I fetal tracing. Patient is on pitocin of 12mU. Patient has been repositioned and hydrated. What is your next nursing action?
What is decrease pitocin by half the dose (6mU).
Patient is now high risk for PPH due to labor augmentation, prolonged second stage of labor and 3rd degree laceration. In addition to postpartum pitocin, what are the three prophylactic medications providers can choose from to prevent PPH (considering no other risk factors).
What is:
Misoprostol 400mcg buccal
Methergine 0.2mg IM
TXA IV
Your patient plans to breastfeed exclusively and asks how many times per day should her newborn feed?
8-12 times a day.
Your patient is admitted for TOLAC. Her VE is 2/50/-3. What is the only accepted augmentation/induction medication you expect the provider to order?
What is Oxytocin.
Low urine output, diminished deep tendon reflexes, shortness of breath, blurred vision and headaches are classic signs of
What is magnesium toxicity
Patient is on pitocin of 10mU. She has cat I tracing. Uterine resting tone is >20mmHg as noted by the IUPC. You have adjusted and flushed the IUPC, but resting tone remains elevated. What is the next course of action?
What is: stop pitocin and notify the provider.
Which stage of PPH is defines as
QBL >1500ml
or 2 units transfused
or risk of occult bleeding
or coagulopathy
or abnormal vital signs/labs/oligouria
What is STAGE 3
What is the priority nursing action to prevent heat loss on newborns immediately after birth?
What is skin to skin with mother and cover with warm blankets
Your patient reports severe abdominal pain. You note cat II tracing and loss of fetal station in VE. What do you suspect?
What is uterine rupture
What is HELLP syndrome.
What is an adequate amount of contraction range observed by an IUPC?
What is 200-250MVU