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Discussion

Charting MVU's

Does anyone know the ACOG or AWHONN standards for how frequently you should figure and chart MVU's? Or is there even a standard? I am a travel nurse, and the facility I am at now places IUPC's in every patient. We are expected to chart MVU's every 15 minutes. Does anyone else think that is unnecessary? I have always figured and charted mvu's hourly, with fht and contraction pattern every 15 minutes in active labor, while eyeballing the strip the rest of the time to look for problems. This is a very small hospital with antiquated charting procedures, most of which I can deal with, but this MVU thing is driving me crazy!!

:confused::confused:

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They put an IUPC on everyone?? Yuck! What's their C/S rate? I don't know what charting standard is, I chart hourly.

Wow....it's very unneccessary to have IUPCs in every pt! If the pt is not on oxytocin, I chart them hourly. If they are on oxytocin, I chart them everytime I should be increasing it....so 30 minutes. This is a recent change for us though, because we used to chart them every 15 minutes also....but that was when we were increasing oxy every 15 minutes.

Our hospital does not place IUPC's... ever! In 8 years of work I have never seen one, even for a Pit. drip!

We chart them every 30 minutes. I am not certain, but I think that our educator said we actually chart a little too often, that as long as there aren't any problems, you can do "summary" charting on them every hour.

They put an IUPC on everyone?? Yuck! What's their C/S rate? I don't know what charting standard is, I chart hourly.

Not to mention their infection rate?

Studies show that an IUPC does not increase the infection rate in lady partsl deliveries, just in sections.

AWHONN does not have a standard as to how often to calculate MVUs. In fact, not everyone calculates MVUs. Many places just chart contraction strength in mm over resting tone in mm. I think MVUs give you more information.

The only standard is to chart contractions at least q1h or whenever doing something to change the contractions: changing Pit rate, giving tocolytics, etc., or when the contraction pattern changes on its own.

Every 15 min seems a bit much. Especially as you're figuring MVUs during a 10min window of time.

  • Author

Thank you for all your responses. I will just chart MVU's hourly like I have always done, or if increasing pitocin. I think it is ridiculous to chart every 15 for a 10 minute time period, it is like continuous charting. If someone says something to me, I will just explain my reasons why since there is no standard. I have 11 weeks left on this assignment, so I just have to make it through that short period of time, and then hope my next assignment is in a hospital with less invasive monitoring.

The hospital where i work we dont chart MVU, we do calculate them just to know if UCs are adequate. if i were you i would look at the policy of the hospital and inform my self how they document, if something was every to happen you wont be covered if you dont follow hospital policy. In my hospital many nurses do things different, i always resort to hospital policy and procedures, and i find nurses in unit learning.

can anyone given me inout: iupc in place with resting tone of 40-45, UCs where every 1.5-2 intensity was 50-60, what would you do? by the way i tried to reset resting tone, flush, and check placement.

Sounds like an irritability pattern. Some would say "pit her out of it". I've had mixed results with that. Often low-dose pit will help someone like that get into a good pattern.

If she's been on pit for a while and her pattern is like this, it's possible her oxytocin receptor sites are saturated and need a break for a couple hours.

That's a really high resting tone. Did her uterus palpate soft betwitioneen contractions? If not, was she abrupting? That's always my first thought when I get a high resting tone. Document what you palpate as well as what the IUPC says. Or was there an interuterine infusion that was not leaking out? It's rare, but possible to rupture a uterus that way. If her resting tone really is firm even between contractions and the IUPC is probably right, let her doc know right away and your charge nurse too. You could be on the way to the OR. I'm not saying open the room, but let the charge know that there may be a problem developing. If the uterus palpates soft, and your attempts to flush and rezero the baseline when it's open to air don't help, the IUPC probably needs to be replaced.

She's having more than 5 contractions in a 10min period which is tachysystole according to the NICHD defininitions. If she's having more than 5/10 min, averaged over 30min, turn the pit off or turn it down, even if the baby is tolerating it. It won't for long.

My facility doesn't chart MVU's at all we just do the intensity and resting tone and try to get the contractions 2-3 mins apart. We do place IUPC's if pt is has a high BMI and it is difficult to pick them up externally.. also if they have been on Pitocin and their cervix hasn't changed (we will get a more accurate picture of true contraction strength)

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