Aminioinfusion

[winter_green]

I don't know what to do. I'm a new grad RN and according to our policy, when amnioinfusion, we use IV pump - 600 ml/hr then 180 ml/hr afterwards. But other nurses on the unit hang LR to gravity. My nurse preceptor taught me to not use the IV pump. Different nurses will have their own say about using the IV pump or not. I can see both stance, but so unsure of what do to.

What do you do at your L&D unit?

[AggieNurse99, BSN, RN]

Always follow your policy. In my state, the NPA reads that if the nurse is following an approved policy, it is within scope. ALWAYS FOLLOW POLICY. No matter who tells you not to. Your employer will hang you out to dry should something go amiss.

[winter_green]

I agree.

Then there's the other argument, is our policy really up to date with AWHOON? AWHOON recommends not using IV pump for aminioinfusion?

[Esme12, ASN, BSN, RN]

I agree.

Then there's the other argument, is our policy really up to date with AWHOON? AWHOON recommends not using IV pump for aminioinfusion?

I doesn't matter....you act outside of the policy and procedure you are out of your scope of practice. My question is does it state in the policy that the use of the pump is Manditory??? or optional.

Policy and procedures are reviesed and updated by your department and department heads....check with your manager and clinical spec/educator and bring the current guidelines to the forfront and ask them their rationale for using or not using the new guidelines....

[tewdles, RN]

Follow your employers policy.

If you think the policy is incorrect investigate and get in touch with your OQ or other appropriate department to suggest corrections.

In the meantime, you will "sink or swim" according to the policy written and in effect in your workplace.

[NurseNora, BSN, RN]

AWHONN is OK with or without a pump (see Principals and Practice of Fetal Monitoring). Some people think a pump could force too much fluid into the uterus and cause it to rupture. But the pumps we use today are sensitive to pressure and will not do that. They'll stop and tell you you have an occlusion.

So follow your policy. Also be sure you are assessing her uterine tone and that it is not increasing. And be sure she is leaking as much fluid as you're putting in. Estimate.

Sometimes if the head is really low, the fluid can't escape and that is the time you could rupture her uterus.

Often the contractions will become stronger, just be sure the resting tone is not increasing. Somebody's law (Sterling?) says that the more a muscle is stretched, the stronger the contraction. Think about the principals of cardiac filling.