Vital Signs
These Vital signs should be assessed on admission and every 4 hours in low risk patients
Should be checked hourly in high risk laboring patients
Should be checked on admission, every 2 hours x2 and on a 9 and 3 schedule.
What is B/P, Temp, Respirations and Pulse
(know your standards for special circumstances, you can never check too many vital signs)
This is performed as a post delivery and postpartum assessment tool to verify stability and hemodynamic stability
What is fundal and bladder assessments
"If it isn't __________ it didn't ___________"
What is "if it isn't charted it didn't happen"
This medication is scheduled for administration to decrease inflammation and pain in postpartum patients
What is ibuprofen
This is the definition of a low risk pregnancy/patient
What is the absence of any maternal or fetal factors that create a risk for poor prenatal outcome
This is considered the 5th vital sign and should include goals for management
What is pain
(patient stated pain assessments as well as patient stated pain goals must be assessed and documented on admission, with change of labor status, post procedure, and postpartum)
Late preterm infants (34-36 6/7 weeks) require additional support and assessments including these
What are blood sugar checks, temperatures and supplementation (pumping or formula)
This charting tool is a "one stop shop" during emergencies creating a timeline and encouraged for ease of use
What is the maternal emergency narrator
This medication is used to increase hypertensive patient seizure threshold, provide neuroprotection in preterm babies and can be used in preterm labor because of it's effect on smooth muscle
What is Magnesium Sulfate
An occurrence of post partum hemorrhage can occur after discharge for the same reasons that patients were high risk in the hospital including an up to this time frame
What is up to 6 weeks
(how are patients educated about pp risk factors? What are they?)
Thermoregulation in infants is imperative for their stability, this temperature range is considered acceptable when assessing a term uncomplicated infant
What is 97.7-99.5 degrees Fahrenheit
Head to toe assessments of all systems should be completed and documented this often
What is on admission and at least every 12 hours
This documentation helps to identify problem areas, measures progress and interventions for chief complaints and guides education interventions for patient teaching. Also known as "not my favorite" in nursing school
What is care plans
(these should be reviewed at minimum once per shift. As new "problems" or changes in phase of care are introduced should also be reevaluated)
Used to treat postpartum hemorrhage, this medication should not be considered a first choice for patients with active asthma and respiratory complications
What is hemabate (carboprost tromethamine)
Introduction of certain types of these could potentially lead to altered maternal hemodynamics, create uterine stimulation and pose a potential for a high risk situation.
What is medications
Pulse Oximetry Screening for an infant occurs in this time frame
What is after 24 hours and PRN as dictated by infnat condition
Feeding Assessments and LATCH scores are assessed and documented in this time frame
What is within one hour of birth, encourage every 2-3 for breastfed babies and every 3-4 hours for formula fed babies, and as per the lactation feeding plan.
The postpartum hemorrhage risk score should be reviewed and evaluated this often with scores communicated for prevention and interventions
What is on admission at least once per shift and with intervention introduction.
(this has also bee taught as at least every 4 hours, you can never check this score enough :))
Not a medication, but a blood product, this is not sent from pharmacy but from the blood bank to prevent Rh incompatibility
What is rhogam
The definition of high risk
What is "any maternal or fetal factor that could lead to poor perinatal outcome" (ie... hypertension, DM, PPROM, prematurity, postmaturity, smoking, substance use etc...)
Orders for vital sign assessments that appear in this way can be found in what order set/policy
Upon initiation of the infusion, assess and document B/P, P, respirations, pulse oximetry, LOC, patient tolerance and response:
a. Every 15 minutes for the first 2 hours of infusion
b. Every 1-hour for the remainder of the first 24 hours of magnesium sulfate infusion.
c. After the initial 24-hour period, nighttime assessment frequencies should include vital signs and pulse oximetry every 4 hours if patient is otherwise clinically stable. The need to increase the rate or bolus the patient during these nighttime hours will necessitate resuming every 1 hour monitoring. Hourly assessments should resume by 6 am and continue until the patient's nighttime sleep.
What is Magnesium Sulfate IV Bolus and Maintenance orders also found in the preeclampsia and HELLP policy on sharepoint
A blood pressure of 160/110 and a blood pressure of 170/85 requires the same amount of intervention and attention because of this concern
What is severe range blood pressures
(severe range blood pressures and a both or either or reportable and treatable event)
This risk score is initiated in triage, when all of the questions are answered the score appears on the dashboard
What is the PPH risk score
This anti fibrinolytic medication prevents the destruction of blood clots reducing bleeding and DIC
What is TXA (Tranexamic acid )
Three Risk factors that contribute to an increased incidence of postpartum hemorrhage
What is placental abruption, placenta previa, overdistended uterus, multiples, multiple previous births/pregnancies, prolonged labor, infection, obesity, medications, medications to prevent preterm labor (mag), hypertension or preeclampsia, assisted delivery, c section.