Ok, most of our residents are really great, nice, respectful, and intelligent people, and most know when they're in over their heads & have to call the upper-level or the attending. This post is NOT about those residents.
Nice young lady came in at 37+3 with her 3rd baby. Ctx q15 min, 3-4cm dilated & about 40% effaced, and ctx are moderate to strong per L/D nurse. Instead of letting her labor on her own and go at her own pace, which with two prior NSVDs, is highly likely to happen, resident ordered to start Pit and AROMed her!!!:trout:
So no flippin' wonder when I get this baby in the nursery she is gray/blue, retracting like a turkey, and has got all kinds of stridor!! What the heck were they thinking!!! Sheesh.
On another note, which has nothing to do with the residents, why the heck to we pump so much fluid into c/s patients?? It's really a wonder they don't have pulmonary edema or cardiomyopathies more often. I really don't like the order that says fluids @ 125/hr x 24 hours!! JMHO.
Not a nurse and rarely work OB, but 3000cc in 14hrs??? What goes in must come out. What about fluid overload? People can die from dehydration and from receiving too much fluid. I find this very scary.
In your depts, do you monitor I&O? The last time I worked the nurses laughed when I mentioned that. But i figure if they're on IV's and were receiving boluses output should be monitored to make sure it's coming out.
We are required to monitor I and O on all laboring and recovering moms and moms on magnesium.
I worked OB last weekend and took care of a mom who had had a C-section. I figured she rec'd lots of fluids before and during surgery to make up for any blood loss but when I stated that to the nurses, they laughed and rolled their eyes at me. And when I said I'll open up an I&O flowchart I was told not to.
I may not be a nurse, and I apologize for hijacking the thread, but I think this is poor practice. We also had a high risk mom who was NPO and not on I&O. I think this is poor nursing practice (the nurses I work with, not you guys).
I come from med surg where if you're on IV fluids you're on I&O so it's hard for me to grasp the rationale not to monitor OB pts input and output.
I come from med surg where if you're on IV fluids you're on I&O so it's hard for me to grasp the rationale not to monitor OB pts input and output.
bethin,
You are having a hard time grasping their "rationale", because there IS NO rationale to grasp. Just laziness, poor practice and complacency. When some poor mother becomes critically ill with CHF caused by fluid overload, perhaps they will change their ways.
Our orders specifically state to measure I/O until IV is d/ced. Jolie is right...what you saw, bethin, is VERY poor practice and is inappropriate. We I/O everybody until their IV is out.
bethin
1,927 Posts
Not a nurse and rarely work OB, but 3000cc in 14hrs??? What goes in must come out. What about fluid overload? People can die from dehydration and from receiving too much fluid. I find this very scary.
In your depts, do you monitor I&O? The last time I worked the nurses laughed when I mentioned that. But i figure if they're on IV's and were receiving boluses output should be monitored to make sure it's coming out.