allergic reaction during prepidil induction or ..razor burn?

[greenykilt]

Alright, me again and my shadowing. Apparently I should get used to shadowing during inductions as thats all I seem to see :)

Again, another eye opener on having to use critical thinking skills in addition (or in spite of?) what the patient says?

after the patient was given prepidil a few hours after 1st dose, it was noticed that the patient had long stripes of red raised rashes on her upper thighs extending just below the knees. The LnD nurse said "I cant believe I didn't notice that before, any idea what this is?" the patient said "I think it might be from shaving as I shaved before I came in ?"

and it was left at that. But thinking back, the rash was raised, red and puffy a bit, and the width of it was about 2 inches (longer than a razor)

what do you think? was it an allergic reaction (no because didnt see it anywhere else like on the stomach?) or razor burn??

[nrsang97, BSN, RN]

Possible allergic reaction in the beginning stage. Did it get worse as more of the med was given (keep in mind I am not an ob nurse and have never given this med before.)?

[mamamerlee, LPN]

Good question. Sensitivity of some kind, but in stripes? Was it seen by the MD?

Very curious!

[kanzi monkey]

Sounds like...tape? Any reason she would have had tape there? If not, I would go with the shaving or maybe scratching theory. Unless the drug itself was somehow applied directly to the skin in that pattern.

[NurseNora, BSN, RN]

Did she have any other allergic symptoms? did she know it was there? did she know how long it had been there? does she usually have this kind of reaction when she shaves? Did the nurse you were following tell the doctor? Look Prepidil up or call the Pharmacy to double check on possible reactions to the product? Did she chart it when she noticed it?

I've never seen a reaction like that, but I haven't used Prepidil in years. I would have charted the appearance (skin assessmetn is a part of nursing care, no matter what department you're working in) and what the patient said about it. I'd probably have notified the doc too. If your doing this on days, I'd call the office and say it wasn't an emergency, but I'd like to talk to him before whatever the next dose was due. If working evenings, I'd tell him when I did my bedtime report to him ( I know when most go to bed and give them a call with an update on the patient's status and ask for any orders I might need during the night--something for sleep, something for a headache or heartburn, that kind of thing. I hate waking anyone up at 3am for Maalox, but I don't want my patient to be suffering with heartburn all night either).

A lot of hospitals are doing mostly inductions these days. There may not have been many spontaneous labor patients to choose from. At least you got a delivery with one of your inductions, even if it wasn't anticipated.

[babyktchr, BSN, RN]

wonder if she waxed instead of shaving?