maberRN

1. Call for help depending on the amount of bleeding ( spotting vs hemorrhage) assess bleeding and fetal heart rate provide O2 if fetal heart rate warrants obtain IV ACCESS Obtains labs, CBC, type and cross, DIC again based on amt of bleeding Gather toco lyrics if contracting Call report

I have enjoyed finding this question stream! I work at a high volume 6,500-6,700 deliveries a year medical center . We absolutely keep our insulin drip patients in labor and Delivery if they are laboring. And we often keep our DKA pts in our high risk antepartum unit. All our new grads and new hires get a 4 hr class on diabetes and pregnancy, and all RN staff attend an OB Emergency Training ( OBERT) class every 2 years that has a DKA section taught by one of our MFM Docs. Sending obstetrical pts to ICU which is centered on lab and blood gas values for non pregnant pts is not best practice. OB pts have different ABG values and normal lab values. It is a one on one assignment if pt is critically ill.

We do the same bonus after delivery at my large 6,500-6,700 delivery a year hospital. However, we run the PP Pitocin at 40 ml/ hr x4 hrs. Our main IV line of NS is KVO’d to avoid fluid overload, with or without Magnesium running.

In my labor and delivery unit, everyone picks up a unit phone, signs in with our hospital ID and then utilizes it all shift for paging doctors, stats etc. you then hand off your phone to the oncoming nurse. We have extras, when the phones need to be charged. They only work on hospital WiFi so there is no use in stealing them.

Hello, 1. At my hospital we do an UDS on all OB admission. Our state law requires assent, not consent. With the increase in opioid addiction, we find MANY positives on patients you would never guess. The neonates then withdraw in the hospital under care, rather than being sent home immediately. 2. Our drug of choice for labor is stadol. We have not used Nubian in years. 3. We perform bedside ultrasounds on all inductions, and all service patients in labor. Our private attending pts do not get ultrasounds unless the triage nurse was unable to confirm vertex presentation with the initial lady partsl exam. 4.If you have a non reassuring fetal heart tracing, pitocin should be discontinued. If you are decreasing pitocin due to tachysystole, pitocin may be halved instead of turning off. 5. IMO doing a cord blood gas is not cost effective in this day of bundled care/pay. We have protocols to draw cord gasses ie: apgars less than 5, assisted deliveries, stat c/s due to NRFHR.

This is an interesting thread! At my large level one trauma center we allow children 14yo and older to be a pt's support person. We also allow newborns to stay with mothers who are readmitted due preeclampsia on the high risk OB floor. (Preeclampsia can be diagnosed up to six weeks post partum). There must be a support person to care for the infant due to the fact they are not considered a pt. When working in our OB/GYN triage we have often been forced to deal with young children coming in with our female patients. If they are going to be admitted, then social service is called for emergency foster care. Often when we start this process, the patient is then able to call out of state family who can pick up in the AM. If a child gets hurt, or lost while the mother is a patient, it ultimately is the organizations responsibility. This is why states have emergency foster care.