PPROM In preterm patient

[Altalorraine]

When a preterm patient (not in labor) ruptures her membranes and fetal heart rate drops significantly and does not come back up after turning patient, what would you do (other than call for doctor to come to room, O2 and fluids open).

AL

[meanmaryjean, DNP, RN]

never mind

[ashleyisawesome, BSN, RN]

If I worked at a place where there wasn't a physician on the floor at all times (ie, had to call them from home or another floor in the hospital), I might consider a sterile lady partsl exam to make sure there are no presenting parts in the lady parts or a prolapsed cord. I would definitely at least look at her lady parts and make sure nothing is hanging out (foot, cord, etc). Where I work there is always at least a resident and an attending close by (can be in the room in seconds) so I would just call for help and expect them do an SVE or speculum exam/ultrasound unless I saw cord protruding from the lady parts, because I don't usually stick my hands in preterm patients who aren't in labor when I have a doctor around to do it. I would probably call another nurse to bring a stretcher and keep it by the door, and make sure she isn't wearing jewelry and ask her when she last ate/drank, in case the doc calls a stat. I would continue to change positions until the doctor got there (left, right, knee chest).