L&D skills

Policy and Procedure

100

A patient being induced- Pitocin running and currently has an epidural- at what frequency are I&O to be calculated

Q 1 hr.-

Utilize patient education sheet to accurate tracking

200

Name when CHG baths are to be done and where it is documented 

On admission, after 9am labor huddle, prior to going to OR.

Daily care and pre-op checklist

300

A patient with SROM being induced with PO Cytotec what is correct frequency of vital signs

Q40minx4- FHR, MT-HR, contractions

Q1hr- BP, R, Pain

Temp Q2

400

At the 15min vital sign check after initiatiing a blood transfusion that patient is tachycardic, has a headache, SOB and hives- what are next steps

STOP transfusion

notify provider

document interventions- per provider order (labs,fluids meds)

Notify blood bank- send product and tubing to lab

500

When in OB PACU- name the criteria that must be met before transfer

Aldrete score equal or greater to 10

BP+ or - 20% pre-anesthesia level, RR rate >10 and <30

O2 stat greater than 92% room air

No excess bleeding

urine output at least 30 ml- note appearance

minimum sensory of T10

patient is able to lift knee off bed

oriented and respond appropriately to questioning

not be vomiting 

Equipment

100

PCA is ordered and started in PACU- what are  2 times will a dual sign off be needed/expected

Upon initiating- and

rate/dose verify when giving report on PP

200

Patient is requesting nitrous- after ensure the tank is full, where does the green cord connect to

O2 BEHIND tree

300

Button that must be pressed on Defib to switch to tracing of ECG vs PADS

LEAD

400

A patient who has retained products is in need of what procedure-and 

explain the steps of setting up the machine

correct lid and tubing size

curate size per provider order 

500

When a provider is requesting the need for a cystoscope following a C/S- name all equipment and supplies needed to be opened and/or ready

Cystotower

Camera/light cords

Cystoscope set

fluid and tubing 

Maternal Emergency

100

The Jada is best utilized for which type of Hemorrhage - name the other causes of Hemorrhage

TONE -Jada- 120/80- will STOP bleeding if correctly inserted

tissue

trauma

Thrombin

200

in triage a patient presents with left sided weakness and slurred speech- what needs to be done and how 

STROKE alert- 24444

Notify provider- call stroke alert-
IV/labs/BG/vitals

300

patient with the following vitals should have a MAP should be maintained above what value.

118/56, 127 HR, resp 34, temp 38.4, spo2 93

65

Vasopressor

Blood cultures process

broad-spectrum antibiotics

400

What causes the following potential complications.

Skeletal muscle changes, hyperthermia, ketoacidosis, renal failure, death. 

Malignant hyperthermia

anesthesia D/C volatile agents and succinylcholine, hyperventilate patient, prepare and admin Dantrolene- 

Cart in Core 

500

First priority in the care of a patient during an eclamptic seizure is to

ensure patient airway-leading cause of maternal morbidity following an eclamptic seizure is aspiration 

Medications

100

Therapeutic range of the drug of choice to prevent seizure activity in patient with pre-eclampsia 

Magnesium sulfate- 5-8mg/Dl

BONUS 

what is included in 1hr mag check-

Vitals- HR, Bp, RR- SP02- reflexes, clonus- I&O

200

medication given for ectopic pregnancy

Methotrexate

Run through steps and qualifications 

300

There are some patients who are unresponsive to oral iron, or have an inability to tolerate oral intake, as well as patients with severe anemia, who would benefit from what iron supplementation.

Injectafer® (ferric carboxymaltose injection) is indicated for the treatment of iron deficiency anemia (IDA) in adult patients who have either intolerance or an unsatisfactory response to oral iron.

400

A diabetic patient on the columnar drip- BG at 1500- 88 with a insulin rate of 0.6- next BG obtained was 105- what is correct move on chart to find correct rate

one move column to the right and go to appropriate tier- 

rate 1.3

500

Dosage and Frequency of uterotonic agents used for PPH

Oxytocin-IV 10-40 in 1L, 10mg IM

Methergine IM 0.2mg every 2-4 hours

Hemobate IM 0.25mg every 15-90min 8dose max

Cytotec 800mg-1000mg 1 dose

Critical Thinking

100

Frequency at which an IV site is to be assessed 

on placement, Q shift, Q1hr with high/acute medications- mag, pit, blood transfusion

200

The parasympathetic branch of the autonomic nervous system cause what change to the FHR

Decrease the fetal heart rate

300

complex disorder caused by overstimulating of clotting and anticlotting mechanisms 

DIC- Disseminated intravascular coagulopathy

leads to overwhelming and diffuse hemorrhage

predisposing factors- preeclampsia, AFE, sepsis, PPH

400

Severe Pre-E patient on mag, post C/S- where Low BP was given 2L on top of boluses infused during labor for low BP- vitals as follow- What is potential diagnosis

136/60, 36.6, HR106, RR 29, SPO2 92 -1615

115/55, 37, 102,37 RR, 89SPO2

Flash pulmonary edema-

importance of I&O and critical thinking

500

Category III FHR tracing include either:

Absent Baseline AND any of following

recurrent late, recurrent variable, bradycardia

OR sinusoidal pattern