Published Apr 1, 2009
OBGYN*RN
69 Posts
hello everyone! i'm a senior nursing student in my last quarter of bsn school (10 more weeks left!!!) and im completing my last class which is our role transition, preceptor guided experience course (you work the shift of your preceptor 2-3 days per week and act as an rn). anyway i absolutely love ob and i was blessed to get into antepartum for the class (im so happy about it because literally everyone wants an ob postion in my class). so my question is can you guys give me a quick overview on what i'll see on an antepartum unit and what the rn does on these units. during my ob rotation last year they only put us on l&d and postpartum so i have never been on an antepartum unit. i just know from class that antepartum consists of patients who arent ready to deliver but might have complications with their pregnancy. but i was just curious as to whether some of the patients are general med patients who just happen to be pregnant or if it was pregnancy specific complications. just any feedback would be appreciated :-)
knitter523
40 Posts
Our antepartum patients can be in the hospital for preterm labor, PIH, shortened cervix, and also medical reasons such as pyelonephritis. We usually treat the cause (magnesium sulfate drips for PIH or preterm labor) pain meds and hydration for pyelo. Our patients are usually on bedrest with monitoring (continuous or intermittant). Youe assessment skills are utilized and then you initiate orders and care plans for these patients. Remember some of these patients may have psychosocial issues such as family (ie-kids) at home. Boredom is rampant and activities need to be tailored to the needs of the patients. (For example- I knit so maybe teaching a patient to knit or crochet is nice-they can make a blanket for the baby).
Good luck!
bookscrapper
36 Posts
I've been working on a high risk antepartum unit for the last six months. A majority of our patients are pre-eclamptic, pre-term labor, premature rupture of membranes (PROM), bleeding, hyperemesis, etc. On every antepartum patient we have to listen to the fetal heart rate with the doppler. Patients that are in pre-term labor often get nifedipine Q6 hours to stop contractions. When a patient has PROM, they get antibiotics for several days (IV to start then PO). With the pre-eclamptic patients, we're watching for headaches, blurred vision, R epigastric pain and also watching their blood pressures closely. If they get dangerously high (>180/110 usually) they often get delivered. Sometimes we have to put a patient on the fetal monitor.
Sometimes we do get patients with more med-surg like problems but not too often.
Our unit also gets postpartum patients as well. All the pre-eclamptic patients come back to our floor after being delivered; they are on magnesium sulfate for 24 hours post delivery and every two hours we have to monitor vitals, intake and output, edema, and deep tendon reflexes.
Its generally a laid-back floor but there are times when things start to happen and you have to move quickly.
Hope that gives you a better idea of what an antepartum floor is like.
thank you guys so much....that really helps alot more! im excited to get started!
shamikab
6 Posts
Hope u enjoy your preceptorship on antepartum.. right now I'm doing my preceptorship on a postpartum floor doing the same 2-3 days a week..anyways I know that our sister unit ,which is the antepartum, sometimes admit moms who miscarried or delivered early with babies in NICU...so maybe you'll be caring for these kind of patients as well if your unit does the same. From my ob rotation on antepartum, I took care of high risk pregnancy moms with mainly PIH, gestational diabetes, and pre-term labor.. There is fetal monitoring, giving medications, and keeping patient on bedrest..Hope this helps and good luck!
thank you so much! all of you guys have been very helpful with giving me an idea of what to expect. i will keep you updated on my progress!
HappyNurse2005, RN
1,640 Posts
Depends on how "high risk" your antepartum unit is (and your corresponding NICU). higher level nicu tends to have higher risk antepartum patients.
We have anything from preterm labor, PIH, PPROM, pyelo, oligo, funneling membranes, shortened cervix, to uncontrolled diabetes, pneumonia, asthma attack, seizure disorders, psych disorders, severe n/v necessitating TPN, had diabetes insipidus once (put out 8liters in 12 hours), galbladder or appendix removal, pancreatitis, infected stuff, drug abuse, post car accident, postpartum still on mag, etc. if it can happen to a woman, it can happen to a pregnant woman.
apu can have lots of meds, lots of fetal monitoring, very busy and sick patients. Or, they can be relatively stable and it can be boring. THings can change in an instant (had a PPROM patient go to bed at 11pm totally fine, woke up at 4am with ctx, had a baby at 7am). some patients are in there for weeks at a time.
It can be a very busy place, and you will learn a lot.
good luck!