Emergent Delivery for Certified Emergency Nursing (CEN)
Included In This Lesson
Study Tools For Emergent Delivery for Certified Emergency Nursing (CEN)
Outline
Emergent Delivery
Definition/Etiology:
Defined as delivery of a baby after rapid labor, usually less than 3 hours in an unexpected setting
Pathophysiology:
- First stage of labor (Dilation): starts with cervical dilation and ends when cervix is dilated to 10cm
- Second stage of labor (Expulsion): starts when cervix is dilated to 10cm and ends with the delivery of the neonate
- Third stage of labor (Placental): starts with the delivery of the neonate and ends with delivery of the placenta.
Clinical Presentation:
- Rapidly progressing stages of labor
- Amniotic fluid rupture
- Crowning
- Desire to bear down
Collaborative Management:
- Pelvic Exam
- IV fluids
- Pitocin
- Lab work including a type and screen if time permits
- Get ready to catch!
Evaluation | Patient Monitoring | Education:
Hemodynamic monitoring:
Signs of shock for mom. Evaluate for postpartum hemorrhage and don’t forget that fundal massage
Fetal/toco monitoring:
- Don’t forget fetal heart rate should be between 110-160.
- Less than 110 is fetal bradycardia (WE ARE WORRIED)
- Look for cause such as cord prolapse, maternal seizures, paracervical block
Keep that baby warm after delivery
APGAR Score at 1 and 5 minutes = intervention as indicated
Linchpins: (Key Points)
- Emergent delivery is happening now, no time to transport to an OB facility
- You have two patients (even when they are one) so make sure you are monitoring both
- Happy moms and babies are clean, warm and dry.
- Transport is key but both need to be stable prior to going.
Transcript
For more great CEN prep, got to the link below to purchase the “Emergency Nursing Examination Review” book by Dr. Laura Gasparis Vonfrolio RN, PHD
https://greatnurses.com/
References:
- Barss, V. A., & Wolfson, A. B. (2011). Precipitous birth not occurring on a labor and delivery unit. Uptodate Inc. Editor: Ramin SM, Hockberger RS.
- Hutchison, J., & Mahdy, H. (2019). Stages of labor.
- Sheehy, S. B., Hammond, B. B., & Zimmermann, P. G. (2013). Sheehy’s manual of emergency care. 7th ed. / St. Louis, Mo., Elsevier/Mosby.
- Von Steinburg, S. P., Boulesteix, A. L., Lederer, C., Grunow, S., Schiermeier, S., Hatzmann, W., … & Daumer, M. (2013). What is the “normal” fetal heart rate?. PeerJ, 1, e82.
NCLEX
Concepts Covered:
- Circulatory System
- Emergency Care of the Cardiac Patient
- Cardiac Disorders
- Cardiovascular
- Shock
- Shock
- Disorders of the Posterior Pituitary Gland
- Endocrine
- Disorders of Pancreas
- Disorders of the Thyroid & Parathyroid Glands
- Hematology
- Gastrointestinal
- Upper GI Disorders
- Liver & Gallbladder Disorders
- Newborn Complications
- Lower GI Disorders
- Multisystem
- Neurological
- Nervous System
- Central Nervous System Disorders – Brain
- Renal
- Respiratory
- Urinary System
- Respiratory System
- Noninfectious Respiratory Disorder
- Test Taking Strategies
- Note Taking
- Basics of NCLEX
- Prefixes
- Suffixes
- Medication Administration
- Gastrointestinal Disorders
- Respiratory Disorders
- Pregnancy Risks
- Labor Complications
- Hematologic Disorders
- Fundamentals of Emergency Nursing
- Factors Influencing Community Health
- Delegation
- Perioperative Nursing Roles
- EENT Disorders
- Basics of Chemistry
- Adult
- Emergency Care of the Neurological Patient
- Acute & Chronic Renal Disorders
- Emergency Care of the Respiratory Patient
- Respiratory Emergencies
- Studying
- Substance Abuse Disorders
- Disorders of the Adrenal Gland
- Behavior
- Documentation and Communication
- Preoperative Nursing
- Endocrine System
- Legal and Ethical Issues
- Communication
- Understanding Society
- Immunological Disorders
- Infectious Disease Disorders
- Oncology Disorders
- Female Reproductive Disorders
- Fetal Development
- Terminology
- Anxiety Disorders
- Cognitive Disorders
- Musculoskeletal Trauma
- Intraoperative Nursing
- Tissues and Glands
- Vascular Disorders
- Renal Disorders
- Eating Disorders
- Prenatal Concepts
- Microbiology
- Male Reproductive Disorders
- Sexually Transmitted Infections
- Infectious Respiratory Disorder
- Depressive Disorders
- Personality Disorders
- Psychotic Disorders
- Trauma-Stress Disorders
- Peripheral Nervous System Disorders
- Integumentary Disorders
- Neurologic and Cognitive Disorders
- Integumentary Disorders
- Newborn Care
- Basics of Mathematics
- Statistics
- Labor and Delivery
- Proteins
- Emergency Care of the Trauma Patient
- Hematologic System
- Hematologic Disorders
- Developmental Considerations
- Skeletal System
- Digestive System
- Urinary Disorders
- Postpartum Care
- Basic
- Musculoskeletal Disorders
- Bipolar Disorders
- Metabolism
- Cardiovascular Disorders
- Concepts of Population Health
- Musculoskeletal Disorders
- EENT Disorders
- Postpartum Complications
- Basics of Human Biology
- Postoperative Nursing
- Neurological Emergencies
- Prioritization
- Disorders of Thermoregulation
- Writing
- Community Health Overview
- Dosage Calculations
- Neurological Trauma
- Concepts of Mental Health
- Health & Stress
- Endocrine and Metabolic Disorders
- Childhood Growth and Development
- Prenatal and Neonatal Growth and Development
- Concepts of Pharmacology
- Integumentary Important Points
- Emotions and Motivation
- Renal and Urinary Disorders
- Developmental Theories
- Reproductive System
- Adulthood Growth and Development
- Psychological Emergencies
- Growth & Development
- Basics of Sociology
- Somatoform Disorders
- Reading
- Intelligence and Language
- Oncologic Disorders
- Med Term Basic
- Med Term Whole
- Central Nervous System Disorders – Spinal Cord
- Muscular System
- Neonatal
- Learning Pharmacology
- Pediatric
- Psychological Disorders
- State of Consciousness
- Sensory System