Hello!..and ?s about "Flat baby" & "non-VBAC pain"

[Doula4Nurses]

Hi everyone!

I've been lurking here for quite a while, and I enjoy reading about your Labor/Delivery experiences so much! As you can tell from my username, I am a Labor Doula, and I do love it! The nurses and CNMs that I work with often say that I'd make a great nurse. My mil and sil are also RNs, so nursing is in the family. I am STRONGLY considering going into nursing within the next few years (of course I'd love to work in Labor/Delivery or Mommy-Baby), but I haven't decided for sure yet if/when I should go to nursing school. For now, being a Labor Doula is wonderful for me.

The reason why I'm posting: I am about ready to receive my Labor Doula certification! I am preparing to take my exam, and while preparing, I've noticed a couple of questions that I could really use your help with! The first one, I have NO idea of (well...I do have a guess, but that's just what it is, just a guess). I've asked other L/D nurses, and so far I've not had any luck. Maybe someone here will know! The second question: :imbar I'm embarrassed to say that I do remember having learned it about a year ago.....but I forgot it (and can't find it in my notes or any of my books)! Here goes.....

1. What is a "flat baby"? (my guess: this is medical slang meaning the monitor strip is showing that there are few or too slight "variables" with the FHR)

2. I know that with a VBAC patient, constant abdominal pain both during and in-between ctx's could indicate a possible uterine rupture. With a NON-VBAC patient, would might be the cause of such pain?

If anyone could help me out with these questions, I be most grateful!!! I'll be out of town for the weekend, but if I get any responses, I'll thank you on Monday!!! Sorry for rambling so long!

Thanks! :)

[bam_bam]

Flat in relation to the monitor strip means a decrease in variability and no accelerations in the heart rate. Normal variability is 5 to 25 bpm variation from the baseline.

Constant abdominal pain in a non-vbac patient could also mean uterine rupture. It is possible for a uterus that has never had an incision to rupture. Also another possibility is a placental abruption.

Good luck!

[BETSRN]

I'd say "flat" in this case is just the nurse's way of indicating that at that time, the strip has minimal variability. AS far as the belly pain goes, in addition to a potential rupture, the patient's bladder might be full. Often, when a patient has been ;pretty comfortable (say with an epidural) and then she complains of increased pain, the first thing to do is chack the bladder. Often after voiding (or emptying the bladder with a catheter, that pain subsides. Try the easy stuff first and see if there is relief. Good luck with your exam and thinking about nursing school. If I had it to do all over again, I would still go to nursing school. It's the best decision I ever made and I have never regretted it.

[Doula4Nurses]

Flat in relation to the monitor strip means a decrease in variability and no accelerations in the heart rate. Normal variability is 5 to 25 bpm variation from the baseline.

Constant abdominal pain in a non-vbac patient could also mean uterine rupture. It is possible for a uterus that has never had an incision to rupture. Also another possibility is a placental abruption.

Good luck!

Thank you, Beth (bam_bam)!! I'm glad to see that my "guess" was on the right track!! I didn't want to leave it as just *my guess*, though, so you've been a big help to me. :) The answer to the other question makes perfect sense, too! Now that I see it, I really think that I should've remembered that. I won't forget it again! Thank you so much!!

Lori

[Doula4Nurses]

I'd say "flat" in this case is just the nurse's way of indicating that at that time, the strip has minimal variability. AS far as the belly pain goes, in addition to a potential rupture, the patient's bladder might be full. Often, when a patient has been ;pretty comfortable (say with an epidural) and then she complains of increased pain, the first thing to do is chack the bladder. Often after voiding (or emptying the bladder with a catheter, that pain subsides. Try the easy stuff first and see if there is relief. Good luck with your exam and thinking about nursing school. If I had it to do all over again, I would still go to nursing school. It's the best decision I ever made and I have never regretted it.

Thank you, Betsy (BETSRN)!! You've helped to affirm my guess to the first question!

As for the second question, you have brought up some really good points. I think I will include all mentioned by you and "bam_bam" (possible uterine rupture, placenta abruption, and/or full bladder). You two have been a wonderful help to me! :)

As far as nursing school......Thanks for the encouraging words! I'd LOVE to go right now!! I know that it's "right up my alley"! The thing is...(and I don't expect all would understand) is that I'm home schooling my two boys (7th and 10th grades). They are the type that needs that one-on-one, and my older boy's teacher told me once that she didn't have the time to make sure that he learned. So...I thought, "I guess I do have the time!". That was the very brief version of a long story that took years to play out. Anyway....it's a big job, and I don't think that I could go to nursing school and home school them at the same time (and do well at doing both). Being a Labor Doula fits better with my lifestyle for the time being; I'm enjoying seeing first-hand what the nurses do, though!! Before I could attend nursing school, I do have a few prereqs that I need to get out of the way, so maybe I'll pick up a class here and there in the meantime. What do you think about CLEPping some prereqs? Maybe my 10th grader & I can CLEP some college courses together! Oh.. lol.... Here I am rambling once again; brevity is not my 'gift'! Thanks again for your help!

Lori

[BETSRN]

I would definitely attempt to CLEP some courses if you can. Why waste the time, effort and money taking them again? Good idea! You go, girl!