Magnesium Misery
FHR Frenzy
Hypertension Hypnosis
PPH: Code Red
Sepsis Sucks??
100
2 indications for Magnesium administration
What is PEC, eclampsia, gestational hypertension, and neuroprophylaxis, and/or tocolysis
100
2 maternal causes of fetal tachycardia
What is maternal fever, infection, dehydration, anxiety, metabolic conditions, and/or medications?
100
indication for administration of BP Protocol
What is sustained hypertension (>160/110 x2, 15 min apart)
100
The threshold of blood loss to be considered a PPH for vaginal and CS deliveries?
What is >500 for vaginal and >1000 CS?
100
2 SIRS criteria
What is:
Temp >38.0C or <36.0C
HR >90
RR >20
WBC >12,000 or <4,000
200
nursing responsibilities during bolus administration
What is: q5 min vitals (including RR), education of magnesium (including S&S of toxicity), stay with the patient, continuous EFM if >25 weeks or per MD order
200
nursing actions for NRNST
What is lateral positioning, encourage PO intake, extended monitoring, vibroacoustic stimulation (VAS), MD notification?
200
contraindication for administration of IV labetalol
What is HR<60?
200
tools available during a PPH
What is the hemorrhage cart, QBL calculator, and PRN orders/oxytocin bolus,
200
The lactate level that requires a repeat in 2 hours
What is >2?
300
This is the antidote for magnesium toxicity
What is calcium gluconate?
300
This is the minimum amount of time required to observe a FHR in order to determine a baseline
What is two minutes within a ten minute window?
300
Possible side effect of IV hydralazine administration
What is reflex tachycardia?
300
Most common cause for a PPH?
What is uterine atony?
300
Nursing interventions for a patient who has an infection + 2 SIRS criteria
What are draw STAT "sepsis lactate" and obtain Q15min vitals until lactate results?
400
Magnesium is excreted primarily by this organ
What are the kidneys?
400
The primary difference between a prolonged decel and a variable decel
What are duration and shape? Variable: sharp, brief, fluctuating "V" or "U" shaped drop. <2 mins, usually caused by cord compression. Prolonged: sustained drop, 2-10 minutes, sudden profound shift in fetal oxygenation
400
T or F: You must call a provider if you have a sustained sever range blood pressure
What is false? You should begin the protocol and call the provider to update AFTER you've initiated the protocol.
400
T or F: You can administer on oxytocin bolus without calling a provider
What is true? You have PRN orders to give an oxytocin bolus so as not to delay intervention.
400
Nursing interventions for a lactate > 2
What are notify provider immediately, obtain broad-spectrum antibiotics orders, draw blood cx before antibx administration, and repeat lactate in 2 hours?
(If sepsis lactate is greater than or equal to 4 or SBP <90 or MAP <65 follow above guidelines and obtain order for sepsis IV fluid bolus (30mL/kg) over 1 hour)
Call RRT if not responsive to IV fluid bolus or other concerns noted.
500
The 4 signs and symptoms of magnesium toxicity
What is loss of DTRs, RR<12, altered consciousness, and/or a serum magnesium level >8.4mg/dL
500
Characteristics of a CAT 3 tracing
500
Maximum amount of IV hydralazine you can administer in 24 hours.
What is 20 mg?
500
The "4 T's" to quickly identify to causes of PPH
What are Tone, Trauma, Tissue, Thrombin?
500
Criteria for transfer to ICU
What is the patient is unresponsive to IV fluid bolus (2 episodes of hypotension within one hour of the bolus)?
Now they need vasopressor administration and implementation of the 6-hour septic shock bundle