SROM question

[LJR89]

My final yesterday asked (more elequently than I am) what is the next thing to do after SROM in a healthy/low risk pregnancy.

I narrowed down my choices to either:

1)Document

or

2)check fetal heart rate.

I just can't remember what was said in class and I can't find the answer in any of my materials. I know having the whole question would be ideal, but this is all I remember. What do you think?

[bagladyrn, RN]

You can answer this if you think about what happens with SROM. Hint- what else could come out besides the fluid?

[ScrappytheCoco]

Heart tones:) some babies like to decel with ROM....and of course there's always the possibility of a cord prolapse.

[LJR89]

Thank you, makes perfect sense. I was leaning towards the heart rate because if the cord but I always think they are trying to trick me lol I picked document, and feel a little silly now lol

[chare]

So, are you saying that you should have answered heart rate?

Or do you now think some other response would have been more appropriate?

[LJR89]

I should have picked the heart rate. It felt like the right answer. And everyone here seems to agree too.

But my instructors always to tell us to document normal findings, so I figured SROM is normal, they must want me to document. But if I knew the material well enough I wouldn't have let that option trip me up.

[chare]

I don't think everyone here "seems to agree" that heart rate is rhe correct answer. Reread bagladyrn and ScrappytheCoco, and see if there is a common thought.

It would also be helpful if you remembered the other reaponses.

[LJR89]

I did not have a choice that involved checking the color/consistency of the fluid.

The third one might have been call a physician. I guess I just took that one off the table right away.

[chare]

Did any of your choices have anything to do with umbilical cord?

[LJR89]

And I didn't remember an answer that involved either a vag exam or checking for a prolapsed cord. But I suppose they could've been options I just didn't read close enough.

[chare]

checking for a prolapsed cord. But I suppose they could've been options I just didn't read close enough.

And there lies the problem (emphasis mine).

I don't work OB, and have been out of nursing school 20 years, but one thing I remember, in any rupture of membranes you need to know whether the cord prolapsed.

[umbdude, MSN, APRN]

According to various practice tests and my professor, check fetal heart rate first before everything else.