I saw the sign
When is EOS initiated?
Within the first hour of life
A tool used to calculate neonatal early-onset sepsis risk based on maternal intrapartum risk factors
What is the EOS calculator?
You called an MD about your patient having a trend of elevated BP readings requiring initiation of preeclampsia protocol. They said to continue monitoring blood pressures for now but refused to initiate protocol. Where would you document this conversation?
Provider Notification on Worklist, Quantros
Name two signs or symptoms of preeclampsia
Elevated blood pressures, presence of a headache, visual changes, epigastric pain, edema, nausea and vomiting
What blood pressure is considered a hypertensive emergency?
Systolic BP > 160 and/or Diastolic BP >110.
Name two maternal risks factors for EOS scoring tool
ROM > 18 hours, foul smelling or purulent amniotic fluid, gestational age less than 37 weeks, maternal fever > 100.6 x 2, maternal GBS positive or unknown status and persistent maternal tachycardia
What is the reason for using an EOS tool?
To establish a wellness baseline for all infants within the first hour or when infant status changes.
You are starting the initial bolus for magnesium sulfate and are ready to scan it into the EMAR. Who can co-sign your order?
A second RN
You are monitoring a patient who had two consecutive blood pressure readings requiring antihypertensive medications. What is the timeframe to start treatment?
Within 30-60 mins of the hypertensive crisis
A patient arrives in labor triage with an order to "assess for preeclampsia". How often should blood pressures be taken to establish a trend?
BPs should be taken q 15 mins
Name three clinical assessment findings that indicate newborn sepsis?
What is fever, or low temperature, fast or slow heart rate, tachypnea, grunting, poor feeding, poor transition, irritability or lethargy, seizures
What do you do if at any time the status of an infant changes to a different clinical presentation?
Go back to the "EOS risk after clinical exam" table and follow the protocol for the adjusted risk scores based on your current assessment and the changes in care or interventions initiated
How often do you document HR, respiration and BP at the start of Magnesium Sulfate administration?
q 15 mins x 4
You are unable to start an IV. Which antihypertensive medication can you give?
Procardia 10mg PO
What is the proper position to take a blood pressure?
Pt in a sitting position, arm at heart level and feet flat and not crossed.
When do you need to notify the pediatrician regarding a newborn EOS score?
When the clinical recommendation require an order (ie: blood cultures) or changes in clinical status that elevates a newborn's level of care
Your patient is GBS positive but allergic to penicillin. Which alternative antibiotic is recommended for GBS protocol?
Cefazolin has similar pharmacokinetics and mechanism of action as ampicillin.
A patient is receiving Magnesium Sulfate. What labs do you need to review and what documentation do you need to perform in order to preserve renal function?
Monitor creatinine levels and document intake and output as ordered.
You gave 5mg apresoline IVP. When do you need to recheck blood pressure again?
BP recheck in 20 mins
When do you need to start the preeclampsia protocol?
When you have two consecutive blood pressure readings above 160's that meet hypertensive emergency
You assess your baby and notice that they are grunting, with rapid shallow breathing and normal oximetry. What category do they fall in and what intervention would you do?
They fall in the Equivocal/yellow zone and Blood cultures need to be ordered with vitals every 4 hours for the next 24 hours
After receiving treatment for neonatal sepsis, your newborn is being discharged. What instructions are you providing the parents?
Monitor for signs of infection, or any changes in breathing pattern or skin color. Maintain a clean environment to reduce infection risk. Practice good hand hygiene.
Ensure baby is feeling well, whether breastfed or formula fed. Monitor for adequate wet and dirty diapers to ensure proper hydration.
Follow up with their pediatrician in 24 to 48 hours.
Name at least four assessments included in the Preeclampsia Assessment - Inpatient? How often are you charting?
Any signs/symptoms, neuro check, DTR, clonus, respiratory status, edema and patient care. You chart q2hrs.
BMI above 35 receives how much bolus of Magnesium Sulfate?
6 grams
What is the target BP range for hypertensive patients?
Maintain therapeutic range of 130-150/80-110