infection
Name 2 signs of maternal sepsis
What are fever (>100.4 or <96.8) & tachycardia (>90 bpm)?
Additionally: tachypnea, elevated WBC count (>12,000), hyperglycemia (bg >140), altered mental status (confusion, agitation, combativeness)
The most common cause of PPH
What is uterine atony?
4 T's: tone, trauma, tissue, Thrombin
Blood pressure threshold for severe PreE diagnosis
What is >/= 160/110?
This foundational principle of trauma‑informed care focuses on creating environments where pregnant patients feel physically and emotionally protected
What is safety?
A sudden drop in the fetal heart rate following artificial rupture of membranes may indicate this obstetric emergency.
What is cord prolapse?
Name 2 risk factors for development of sepsis in pregnancy
What are: prolonged membrane rupture & prolonged labor?
Also: Intrapartum factors include
Frequent vaginal examinations, especially after membrane rupture
Operative deliveries
Cesarean section (higher risk than vaginal delivery)
Instrumental vaginal delivery
Internal fetal monitoring
Manual removal of placenta
Episiotomy or severe perineal lacerations
Use of invasive procedures (e.g., uterine exploration)
Name 2 risk factors for PPH
What is prolonged labor or multiple gestation?
Also acceptable: uterine atony, trauma, placental problems, or coagulation issues, cesarean delivery, uterine inversion, inadequate active mgmt of 3rd stage of labor
Name a first-line medications for acute severe hypertension in pregnancy
What is: labetalol, hydralazine, or nifedipine?
Name 2 strategies to reduce re-traumatization during vaginal exams
What are: obtaining consent before proceeding & explaining each step?
Name the event: A postpartum patient has heavy bleeding, a firm fundus, and increasing perineal pain with pressure.
What is a perineal/genital tract hematoma?
Recommended time frame for administration of antibiotics in suspected sepsis
What is asap or within 3 hours?
Name 2 standard practices for active management of the 3rd stage of labor to reduce risk of PPH?
What are uterine massage & oxytocin administration?
Also: earlier cord clamping & cutting, controlled cord traction
Name 2 severe features of PreE which require urgent provider notification
What are: BP >/=160/110 mmHg, severe headache/visual changes, RUQ/epigastric pain, elevated LFTs, low platelets (<100,000), pulmonary edema?
Patients with trauma histories may show heightened startle responses, difficulty trusting staff, &/or emotional detachment. These reactions are known collectively as this.
What are trauma responses?
Name the event: A patient attempting TOLAC reports sudden severe abdominal pain, loss of fetal station, and a non-reassuring fetal heart rate.
What is a uterine rupture?
Term for life-threatening organ dysfunction caused by a dysregulated host response to infection
What is sepsis?
Name the newest expectation (to assess for possible hemodynamic changes) for BP checks frequency within the first 15 minutes of oxytocin administration at 500 mL/hour?
What is every 5 minutes x3 at the start of the infusion?
This assessment finding most strongly suggests magnesium sulfate toxicity and this action should be taken
Assessment finding: What are absent or diminished DTRs?
This finding appears before respiratory depression, hypotension, or cardiac changes.
Typical progression of magnesium toxicity:
Action: What is stop magnesium infusion and notify provider?
Also: prepare calcium gluconate
A patient who experienced prior obstetric violence becomes dissociated during a postpartum hemorrhage response. The nurse grounds the patient with calm voice cues and names each intervention. This strategy is an example of this trauma‑informed technique.
What is grounding and reorientation?
During a code blue response on a >20 wga pregnant patient, the time of decision/incision of resuscitative cesarean delivery
What is decision: 4 minutes/incision: 5 minutes?
Name the 3 components of the sepsis bundle recommended asap or within 3 hours of suspected sepsis
What are: blood cultures, broad-spectrum antibiotics, and IV fluids?
Ideally this should occur prior to the delivery to confirm the rate of the oxytocin infusion post-delivery as well as any changes for the maintenance LR rate
What is a Pitocin pause?
This urine output threshold signals concern for magnesium accumulation in a patient receiving magnesium sulfate
What is <30 mL/hr?
During a shoulder dystocia, the team provides clear, step‑by‑step narration of actions while minimizing exposure. This communication approach reduces the risk of retraumatization and is known as this.
What is anticipatory guidance?
Frequency of assessment of vital signs during magnesium sulfate bolus (first 20 minutes)
What is every 5 minutes?