Interesting OB patient

[OBNURSEHEATHER]

I had an interesting patient the other day. 4 day c-section without bowel movement or bowel sounds. I'm not sure what led up to all of this, as this was the first day that I'd had her. Anyways, doc says it's probably an ileus, but that they're just gonna make her NPO to rest the bowel, no NG just yet. Needless to say, after about 3,000 cc's of sh***y emesis (literally), I wound up putting down an NG.

This is where it gets interesting. As I'm leaving at 3:30, infection control calls up to tell us her placental culture came back positive for Group A Strep. I worked about 3 days later, had the same patient again, but by this time we're "specialing" her. Cardiac consults to rule out rheumatic heart type disorders as a result of the Strep infection. Temp hovering right around 39. And to top it off, infection control's report states "suggested that all caregivers be cultured for Group A Strep". They don't think we gave it to her obviously, but that we could have contracted it. My supervisor didn't even know this until I showed her the report that had been on the chart for 2 days! But even then, says that only L&D nurses who would have been in actual contact with the placenta should be cultured.

So my questions are...

How common is this? Has anyone else had a pt. like this?

What are your thoughts on the post partum nurses handling her vomit, urine, loose stools, and lochia not needing cultured? I know we use precautions, but should have the L&D nurses with her placenta.

Just wondering out loud here. I'm very interested in everyone's thoughts.

Thanks,

Heather

[prmenrs, RN]

Group A Strep is what causes "Strep throat", with complications of rheumatic fever and rheumatic heart disease.

[prmenrs, RN]

Glad to know the 7 years I did Infection Control weren't a TOTAL wast of time.

[fergus51]

Originally posted by kday

Gross. Never heard of Group A Strep...only group B. Heather, that is ICKY!!

As for handling the placenta bare-handed....EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWW!!!!!!!!!!

Have you ever SEEN one of those things??? They look like roadkill!! There's no way in HELL I'd ever touch one w/out using gloves!! Bleah!!! I would hope all those L&D nurses w/this patient did the same....GROSS!!

LOL!!! I couldn't agree with you more! EEEEWWWWW!!!!