How do I chart during Epidural procedure?

[jamerss]

Please help!!! I am orienting to a L&D unit and I have different opinions from senior nurses on how to chart during the actual Epidural procedure. Do I chart Mom's Vitals and Fetal heart tones q5 min? or Is it q15 minutes during procedure? What are some of your hospital protocols regarding This

[SmilingBluEyes]

We don't usually chart bladder distension as they get foley catheters most of the time where I work. And no, I don't wish to go and start an argument there. I know some don't. It's usually hours our patients have epidurals, and the sort of blocks they receive preclude any ability to void/empty their bladders. So foley's are placed if an epidural is to be in place longer than about 2-3 hours. WE do chart consent and verbalized understanding of the need for an indwelling catheter, if one is used.

[Peaches N L&D]

I love reading these posts I learn so much I didn't know there were so many different protocols for an epidural, I could not understand q30 min vitals while a continuous epidural is being used (maternal b/p fluctuates during the use of an epidural)surely FHT'S are assessed more frequently.................We do it like this FM yes if the baby stays on during the procedure, VS q5min x5 then q15 min thereafter if VS are WNL. We automatically place a foley unless Dr orders say no because the pt dosen't want it....I have never charted pt consents to foley or verbalizes understanding(that is a good point) :yelclap:

[SmilingBluEyes]

I always chart verbalization of understanding and consent for ALL invasive procedures and treatments from IV insertion to Pitocin use to foley catheterization---and I do it before they are in pain (may indicate duress/severe stress) or have any narcs on board (mind alteration potential). It's been my habit since I graduated----one I developed a long time ago.

[SmilingBluEyes]

Excellent observation and action!! Keep up the good work, SmilingBlueyes.

I just reviewed a case for merit where there was approximately 15 minutes of absent monitoring strips for FHR checks during epidural placement. Without going into detail, this (absence of strips) will be used to strengthen the plaintiffs case.

thank you for that vote of confidence. That means a lot coming from someone of your background!