Labor Induction
A G2P1001 presents to triage in latent labor. She has a prior CS x1. This is an important question to ask her.
What is, "when did you last eat or drink"?
The patient is a 75yo female with HTN, HLD, T2DM, history of recent CVA, on Eliquis. She is s/p an ex-lap for bowel resection and is in the ICU intubated. You are consulted for vaginal spotting. The appropriate physical exam for this patient is...
What is no pelvic exam?
This is the person you talk to when one of the labor nurses is talking about you behind your back
Who is your chief?
What is reassurance?
A patient presents to triage with complaint of contractions. You check her and you determine that she is 2cm dilated. You are 99% sure that what you felt is a head. This is your next step.
What is, do an ultrasound?
You are called to the BGH ED for a G2P0010 @7w0d by LMP who is having brownish spotting of two days duration and mild cramping. This is the appropriate type of imaging for the ED to obtain.
What is trans-vaginal ultrasound?
You set a baby up for a circumcision and you note hypospadias. This is your next step.
What is refer to outpatient urology?
A patient presents for induction. This is something related to her cervical exam that should guide you in determining her induction plan.
What is a Bishop score?
G7P5015 @14w3d presents with severe nausea and emesis that has resolved with 1L IVF bolus and phenergan. This is the appropriate next step.
This is how you contact the attending at 2AM when their patient's baby's HR is in the 60s.
What is a phone call?
Your patient is a G2P2002 POD1 from a repeat c-section. Her pain is not adequately controlled on Percocet. This is how you modify her orders.
What is, schedule Tylenol and Motrin and add Oxycodone PRN?
What is, call your senior?
You have just diagnosed an incomplete abortion in the ED. She is bleeding heavily and needs to go back for a D&C urgently. These are the orders you should put in.
What is NPO, CBC, type and screen, and IVF.
The cure to all sadness.
What is boozy brunch with your co-interns?
A nurse calls you to tell you that a patient who is postpartum from a vaginal delivery is having severe cramping not well controlled with Motrin. This is how you escalate her pain medication regimen.
What is add Tylenol?
Your patient presents to clinic for a routine OB visit. She is 41w0d. This is your next step.
What is schedule her for induction?
Your patient is POD5 from a primary cesarean section and she presents due to drainage from her incision. On exam there is a 1cm opening on the left lateral aspect which is draining purulent fluid. This is the most test to obtain before starting her on antibiotics.
What is a wound culture?
The best way to fall asleep in the morning when you're on nightshift.
What is a blood transfusion?