Standards of Care
When a baby of diabetic mother is delivered I can expect to do these additional labs on baby.
What is a CBC? (Babies who have diabetic mothers are at risk for polycythemia)
What are blood sugars for the first 24 hours per protocol?
This must be completed and documented prior to starting an induction.
what is a Fetal Nonstress Test?
I should enter a Midas whenever this happens
What is something outside of the expected course?
The volume of blood loss that meets post partum hemorrhage definition
What is 500 ml after vaginal delivery or 1000 ml after cesarean section
This needs to be given within the first hour of a pregnant patient having a high blood pressure
What is Medication
My patient is GBS positive. She had quick labor and received one dose of antibiotics 2 hours ago. Membranes spontaneously ruptured shortly before delivery and gestation is 38 weeks. What labs will my baby need according the the newborn order set?
What is nothing additional? Thisi baby does not meet the the requirements for a CBC and blood culture. The baby is over 37 weeks gestation and ROM was under 18 hours.
Recurrent variable declarations, late declarations, minimal or marked variability for 40 minutes or longer.
These are some interventions
What is category 2 tracing?
What is updating the provider, request provider evaluate the patient, position changes, stop Pitocin,
The specialty with the highest number of malpractice claims.
Obstetrics
These are 4 actions I can take if my patient has an elevated hemorrhage score.
What are
1. Start a second IV
2. Hemorrhage cart in the room or at the door.
3. Hemorrhage medications in teh room
4. Collaboration with team
other ideas
When caring for a patient on magnesium, nursing will be concerned about toxicity if these signs present.
What are Vision changes, significant change in blood pressure, Respiratory rate unusually slow or fast, respiratory compromise, changes in DTR, .....
Baby baths should be done at 6 hours post-delivery unless
What is nursing discretion to delay the bath due to temperature or blood sugar instability, or any nursing concern?
What is a Parental request for a delay?
What will be done earlier in the case of communicable diseases as described in policy?
Sinusoidal Pattern or absent variability
What is a category 3 strip?
Prepare for urgent delivery
Request provider comes to bedside.
Stop Pitocin
This is why I never put an entry into a patient chart that refers to the placement of a Midas Event report.
Because if I refer to a Midas event in the chart it is discoverable by opposing legal counsel.
This medication to manage postpartum bleeding, requires refrigeration and should not be given to patients with asthma, liver or renal disease.
What is Hemabate?
This needs to be taken within 15 minutes to follow up on elevated blood pressure
What is blood pressure
When admitting and induction a patient, prior to beginning any induction medications I need to do this_____ and document the results. As found in the order set
Fetal Non Stress test
This number or over is considered hypertonia when a IUPC is in place
What is over 25 mm Hg
Providing care within these guidelines provides protection to nurses
What are policies, procedures, and Elsevier skills?
I can't use this Methergine to manage postpartum hemorrhage if my patient has,
What is hypertension?
A patient arrives in triage, gestation is 32weeks, 6 days. She complains of headaches. The initial blood pressure is 152/96.
She needs a repeat blood pressure within this time frame.
She needs medication with in this time frame
What is within 15 minutes?
What is within 60 minutes of the first high blood pressure
The postpartum mother has developed a temperature is 100.5 10 hours after delivery. I can plan to do these labs on the baby.
What is a CBC with dif and a blood culture per newborn admission order set?
When an IUPC is in place this is a normal resting tone.
What is 10 mm Hg
In the event of a poor outcome opposing legal counsel can get access to these items of information.
What is Tracer badge activity?
What are relevant social media activities?
What is personal phone and internet use on the unit at the time the patient was receiving care?
This is a leading cause of maternal mortality
What is Postpartum Hemorrhage
This condition is associated with epigastric pain, shoulder pain decreased renal function, risk of placental abruption, and thrombocytopenia
What is Hellp Syndrome?