klone MSN, RN

Nurse Leader specializing in Labor & Delivery

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All Content by klone

  1. klone

    Case Study: An OB Catastrophe

    klone replied to Corey Narry's topic in Critical Care

    At least one of the studies on propofol was on women who were on a continuous infusion. But yes, most of the studies on Fentanyl focus on its use in
  2. klone

    Case Study: An OB Catastrophe

    klone replied to Corey Narry's topic in Critical Care

    Remdesivir - given IV because it is poorly absorbed orally. As such, infants are unlikely to absorb clinically significant amounts of the drug from milk. In addition, newborn infants have directly...
  3. klone

    Case Study: An OB Catastrophe

    klone replied to Corey Narry's topic in Critical Care

    Fentanyl is also rated L2. It has low oral bioavailability, which means that very little of what is in the milk will actually get into the infant’s bloodstream. According to Hale, “The relatively...
  4. klone

    Case Study: An OB Catastrophe

    klone replied to Corey Narry's topic in Critical Care

    Okay, reading about Propofol (continuous infusion). It’s categorized as L2 (probably compatible). Only very low concentrations are found in breastmilk, and it is rapidly cleared from neonatal...
  5. klone

    Case Study: An OB Catastrophe

    klone replied to Corey Narry's topic in Critical Care

    Yes, I understand these are IV meds. My point regarding oral bioavailability is how bioavailable are these IV meds when ingested orally (by the infant). Many IV meds will pass right through the system...
  6. klone

    Case Study: An OB Catastrophe

    klone replied to Corey Narry's topic in Critical Care

    I understand. And I will look them up tomorrow when I have the resources in front of me. Can you list what the specific medications are? Propofol,
  7. klone

    Case Study: An OB Catastrophe

    klone replied to Corey Narry's topic in Critical Care

    One needs to keep in mind that the amount that goes through to the breastmilk is a very tiny percentage. Also, there is the question of oral bioavailability, as well as protein binding. That’s why...
  8. klone

    Case Study: An OB Catastrophe

    klone replied to Corey Narry's topic in Critical Care

    Are you familiar with Thomas Hale’s “Medications and Mother’s Milk”? That’s the text that we rely on to determine if a medication is okay with breastfeeding. As far as I know,...
  9. klone

    Case Study: An OB Catastrophe

    klone replied to Corey Narry's topic in Critical Care

    Are you sure that it’s contraindicated for the
  10. klone

    Case Study: An OB Catastrophe

    klone replied to Corey Narry's topic in Critical Care

    You sure about that?
  11. klone

    Case Study: An OB Catastrophe

    klone replied to Corey Narry's topic in Critical Care

    You’re right - It used to be thought that entry of fetal cells into maternal circulation is what caused AFE, but now we know that fetal cells are present in maternal circulation a good percentage of...
  12. klone

    Case Study: An OB Catastrophe

    klone replied to Corey Narry's topic in Critical Care

    That's why it has such a high mortality
  13. klone

    Case Study: An OB Catastrophe

    klone replied to Corey Narry's topic in Critical Care

    Here's a great presentation on the use of A-OK protocol for AFE. Sadly, many nurses and even OB providers are unfamiliar with this treatment protocol....
  14. klone

    Case Study: An OB Catastrophe

    klone replied to Corey Narry's topic in Critical Care

    Yep!
  15. klone

    Case Study: An OB Catastrophe

    klone replied to Corey Narry's topic in Critical Care

    Okay, I know labor dude and I are on the same page. I'm going to diagnose this patient with an AFE (amniotic fluid embolism). Even though it's rare, the hallmark sign that that is what is going on is...
  16. klone

    Case Study: An OB Catastrophe

    klone replied to Corey Narry's topic in Critical Care

    I'm confident I know what is going on, but I will let someone else chime in first.
  17. klone

    Case Study: An OB Catastrophe

    klone replied to Corey Narry's topic in Critical Care

    Just have to say woohoo!! I love reading the case studies, and it's finally my time to SHINE!
  18. klone

    Case Study: An OB Catastrophe

    klone replied to Corey Narry's topic in Critical Care

    No - we have women who have PPROMed at 20 weeks hang out in antepartum for months. We watch closely for infection and fetal wellbeing. Assuming both of those things are fine, we try to keep them...
  19. klone

    Case Study: An OB Catastrophe

    klone replied to Corey Narry's topic in Critical Care

    Not typically, unless she starts to show signs of infection or her GBS comes back +. Latency abx for PPROM (preterm premature rupture of membranes) is generally only recommended <34 weeks...
  20. klone

    What is within scope

    klone replied to katerinsols's topic in Ob/Gyn

    Yes, it is within scope of practice for nurses to do a speculum exam, but most facilities do not allow it until/unless you have demonstrated
  21. klone

    Case Study: An OB Catastrophe

    klone replied to Corey Narry's topic in Critical Care

    That's a good thing. And the oligohydramnios is simply because her water
  22. klone

    Case Study: An OB Catastrophe

    klone replied to Corey Narry's topic in Critical Care

    1: Fever, localized abdominal pain, elevated WBCs, other signs of sepsis such as change in vital signs, fluid that changes from clear to green, yellow, or bloody. Also concerning would be a category...
  23. klone

    BLM rioters cheer as Trump supporter murdered

    klone replied to guest416560's topic in U.S. Politics's Talk Politics

    Oh mah gawd What's weird is NONE of those other articles said anything about groups of people cheering over the death of someone. I guess anything's possible when you make ***
  24. klone

    NCLEX Tips: 5 Ways to Tame the Tension

    klone replied to Damion Jenkins's topic in NCLEX Exam, Programs

    Thanks
  25. klone

    Bad signs? New department

    klone replied to ApplePineApple's topic in General Nursing

    Personally, I wish more people utilized the free text nursing notes. Tells a much robust story than clicking a bunch of