ERAS
Should be on minimum 18 hours a day while in chair or bed until 24 hours post op.
What is the most important step in neonatal resuscitation?
Ventilation
Patient received Cytotec, she has a 30 minute reactive tracing.. can she get off the monitors and ambulate?
What does the acronym RACE stand for?
Rescue, Alarm, Contain, Evacuate
Name one opportunity to document a pain assessment.
Admission, with medication administration, 1 hour post medication administration, prior to procedure, post procedure etc...
When should the patient be OOB to chair post operatively?
within 8 hours once sensory motor skills are WNL
What oxygen concentration should be used with PPV during chest compressions?
100%
Does the patient receiving an epidural require continuous fetal monitoring?
Every effort should be made to continuously monitor the fetal heart rate. Monitor and document intermittent fetal heart tones and uterine activity approximately every 15 minutes during epidural placement if unable to maintain continuous fetal heart rate tracing during procedure.
What does the acronym PASS stand for?
Pull, Aim, Squeeze, Sweep
When is a sedation score required to be included in pain documentation?
With Narcotic or any sedative administration and 1 hour post.
How often should the patient be encouraged to chew gum post operatively?
3 times a day for at least 20 minutes
What 4 questions should you ask before every birth?
What is the expected gestational age?
Is the amniotic fluid clear?
Are there any additional risk factors?
What is the umbilical cord management plan?
How do you remove a FSE?
Remove fetal spiral electrode by grasping the hub and turning it counterclockwise
If there is a fire in the OR, where should the mother be moved to?
3 surgical
How frequently is a pain assessment required to be documented on a patient with an epidural?
Prior to obtaining the epidural, 1 hour post insertion and hourly until discontinued.
When can the patient be IV locked post operatively?
6-24 hours post op if afebrile, VSS, voiding spontaneously, no excessive bleeding and no nausea
When is PPV indicated?
If baby is apneic
If baby is gasping
if baby's heart rate is less than 100
After how many minutes of unsuccessfully attempting to obtain a reactive NST will it be called non-reactive?
40 minutes
If there is a fire on the unit, how many gas shut offs do we have?
4- 1 in Nursery
1 in OR
1 for 300-309
1 for 310-321
List 4 non-medication pain relief measure for infants.
a. Non-nutritive sucking (NNS)
b. Facilitated tucking/use of supportive bedding
c. Swaddling
d. Reduction of environmental stimuli
e. Attention to behavioral cues/support of neonate’s attempts to self-regulate
f. Kangaroo care (skin-to-skin contact)
g. Breastfeeding
h. Expressed Human Milk
i. Administer oral sucrose
When can the foley be discontinued post operatively?
6-12 hours post op once sensory motor skills are WNL (unless epidural in place, decreased perfusion, strict I&O)
You have administered an IV dose of epinephrine to a newborn. What do you flush the IV with and how much?
Saline / 3ml
If you have a questionable tracing that concerns you, what do you do?
Communicate with buddy, charge, provider
If there is a fire, how do you report it?
Pull the alarm at L&D
Can also call 12 but the alarm is needed to call Fire Department
Can you give any PRN pain medication for complaints of pain?
No each order has criteria for the medication to be given.