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Labor of Love 707 Views

Joined: Sep 24, '07; Posts: 6 (50% Liked) ; Likes: 3

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    Our Cyto is kept on the unit in Pyxis

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    I do not care for cytotec, although our MD's use it all the time. I see so many times a bit of hyperstim or very irregular contracting. Unlike cervidil, cytotec is not easy to remove if hyperstim occurs. I do however think it does soften the cervix. During your research and making of your protocol, will you have patients sign a consent prior to placing cytotec? Or do your MD's have patients sign a consent prior to induction?

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    CEG likes this.

    Quote from CEG
    The antibiotics don't take 4 hours to work, they cover for four hours. So the idea is to get a dose of antibiotics in and then repeat every four hours. I think the maximum effect is achieved after about an hour, depending on the drug used, I guess. We use 1 hour as a general guide.

    As for Group B Strep, around 40% of the population carries the Group B Strep becteria. The rate of infection in untreated mothers is 1 in 200. It is closer to 1 in 1000 in treated mothers. There is early-onset and late-onset which have different etiologies but are lumped together statistically. Even a woman with no risk factors can have an infected baby and one with every risk factor can have a baby who is not infected. Babies delivered by c-section can also contract Group B Strep. C-section in the absence of a true indication is more risky for both mom and baby.

    GBS is also transient meaning that even a woman who is positive for GBS at 36 weeks may be negative at delivery and vice versa. GBS status is not considered indication for induction unless there is a history of precipitous labor (which in and of itself reduces risk of infection). So although this woman may have tested positive at her office visit she may have been negative when she delivered. The test takes a long time and cannot be performed in labor and delivery.

    GBS treatment guidelines are outlined by the CDC and can be found on their website. Pregnancy and childbirth are a normal physiological event and rarely an emergency.

    Also, higher doses of pitocin can lead to uterine hyperstimulation and fetal distress as well as dysfunctional labor. Manufacturer's instructors state to use the smallest dose possible. Larger doses will actually tend to slow labor progress.
    Thanks for the great reply!
    I have been reading that they are working on a GBS rapid screen that may be done at the bedside at some point. Like you said, since GBS could be positive one day and negative the next a rapid screen would be more benificial to Mom and Babe. Why introduce abx when not needed and would be nice to get them in when they are!! (Ah in a perfect world):spin:

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    ElvishDNP likes this.

    If after a very busy "sucky" night, if there is ever any doubt, you are in the right place!..Never be ashamed to cry-it makes you human. Once we get calaced, I think its time to go work at Mickey D's!
    You're awesome!

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    KYCNM likes this.

    I feel as though I am a 3rd shift lifer!

    As I push a screaming baby into a room, ask the mom "would you like me to turn the light on?" Looking at her husband who is snoring in the corner "No, shhhh-I dont want to wake him." That is when I want to say...well then he should go home!
    (then the kicker-as she pages me back to the room after refusing help with breastfeeding-"He's not hungry" and sends him back to the nursery-screaming the same way he came into the room!)

    And it was said numerous times but...It must be nice to have a job where all you do at night is rock babies..

    And, my all time favorite-From the mouth of a nurse anesthetist "OB nurses are not real nurses anyway" (almost needing a restraining order!

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    Currently I am an Associate Degree nurse, going on for my Bachelors-for IBCLC, ADN nurses require more hours in order to sit the test. In order to practice, I took a Certified Lactation Counselor seminar. PCE has a very good class. Now I am able to practice while I gain more hours and experience to sit the exam



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