Pre-Delivery
This maternal condition, combined with suspected LGA, increases a mother’s risk for shoulder dystocia
What is gestational diabetes?
This visual sign, when the head delivers but retracts against the perineum, can signal shoulder dystocia.
What is the Turtle Sign?
One-and-two-and-three-and-breathe-and....
What is the proper cadence for compressions with breaths?
A boggy, deviated fundus immediately indicates this cause of postpartum hemorrhage.
What is uterine atony?
This team must be notified immediately when shoulder dystocia is suspected to prepare for potential neonatal compromise.
What is NICU/NNP/NRP qualified personnel?
This maternal physical factor, seen in this patient with a BMI of 38, is a known risk for delivery complications.
What is maternal obesity?
During delivery this person marks the time that the fetal head delivers, and when a shoulder dystocia is suspected, this team member tracks the time from head delivery, calling out 15-second intervals to guide rapid interventions.
Who is a second nurse at the bedside?
These steps are are the final two steps in Mr. Sopa.
What are reposition airway and increase pressure?
This uterotonic medication is given first-line and has already been running on this patient for induction/augmentation.
What is Oxytocin (Pitocin)?
When additional staff enter during an obstetric or neonatal emergency, the primary nurse must clearly state this information first so everyone understands what they are responding to.
What is announcing the emergency and immediate concern: e.g. Shoulder dystocia and newborn not breathing?
This fetal characteristic, estimated at 4,000+ grams, significantly increases obstructed labor.
What is macrosomia (large estimated fetal weight)?
This is a procedure used during vaginal delivery to relieve a shoulder dystocia. It is a procedure that drops the head of the bed and sharply flexes the mother’s thighs toward her abdomen, which moves the pubic symphysis and helps the baby’s anterior shoulder drop down under the pubic bone.
What is The McRoberts Maneuverer?
The infant weights approximately 4.2kg, what is the appropriate ETT tube?
What is a 3.5 ETT?
These two uterotonics have important contraindications: one cannot be given to patients with hypertension, and the other is contraindicated in patients with a history of asthma.
What are Methergine and Hemabate?
During neonatal resuscitation, these two assessments must be communicated clearly and repeatedly to guide escalation of care.
What are heart rate and whether there is effective chest rise with PPV?
This part of labor, already lasting 1.5 hours for this patient, becomes a risk factor for dystocia when prolonged.
What is second stage of labor?
This maneuver is performed by a qualified medical professional applying firm downward, inward pressure (toward the directions the fetal head is facing) above the mother’s pubic bone to help free the anterior shoulder, often paired with the McRoberts Maneuver, and the reason a step stool should be in every patient room.
What is suprapubic pressure?
The term infant is born breathing, does not have good tone, what is the next appropriate intervention?
What is bring to radiant warmer, place leads & pulse ox, dry & stimulate, apply hat & start PPV
These laboratory tests, including a coagulation panel, are drawn early during a postpartum hemorrhage to help assess the severity of blood loss.
What are CBC, CMP, PT, PTT, and Fibrinogen?
When the 7-hour-old newborn becomes blue and not breathing in the postpartum room, the RN must activate this emergency response and verbally communicate the need to begin PPV immediately.
What is pushing the code button and clearly announcing "Baby not breathing-starting PPV" to incoming staff?
This provider intervention performed 5 hours before delivery with clear fluid can influence labor progression and fetal decent.
What is AROM (artificial rupture of membranes)?
This complication, affecting the nerves around C5 and C6, is the most common newborn injury associated with shoulder dystocia.
What is a brachial plexus injury?
An infant's heart rate is below 60 what are the next steps to take?
What is to begin compressions, turn FiO2 to 100%, call an over head code, and re-check HR after 1 minutes?
During an active postpartum hemorrhage, vital signs must be reassessed at this frequency, and if bleeding continues despite medications, this device, which is an intrauterine vacuum-induced hemorrhage control system should utilized to control hemorrhage.
What are vital signs should be taken every 5 minutes and the use of the Jada system?
During postpartum and neonatal emergencies simultaneously, nurses must use this structured communication tool to relay maternal status (fundus, bleeding, VS) AND neonatal status (HR, respirations, color) during rapid team arrival.
What is SBAR communication?