Module 5 BBB Early Labor Management

Question 1

A G1 40.2w called at 1 am, thinking she is in labor. She has no sig. medical hx. What would you want to ask her?

Answer 1

Subjective:
-Contraction strength, frequency, and length.
-Are they getting closer or stronger?
-Fetal movement
-Vaginal bleeding or LOF?
-How are you coping? Can you talk through your contractions?
-Have you tried anything to help with the pain?
-GBS status
-How far away do you live?
-What is your plan for pain management?

Objective:
-Listen for how she reacts during a contraction

Question 2

You diagnose a phone triage call as in early labor who is coping well. What is the best thing to tell them?

Answer 2

Based on what you’re describing, you are likely experiencing early or pre-labor. This can last hours to days. It sounds like you are coping well right now, so I would recommend you stay at home. If you are having trouble sleeping or resting, you can take a bath or shower to help ease the discomfort, have your partner give you a massage, meditate, listen to music or do something distracting but restful. As long as everything is normal and you can cope with what you are feeling, the safest and most comfortable place for you and your baby is at home. Ideally, you will come to the hospital in active labor. If you are not in active labor, there are things we can do here to help you cope until you are. You can always call us back to chat if you have questions or concerns, or you can come in if you feel that is best, or it would give you peace of mind.

If you think your water has broken or your contractions are worsening, and you are having trouble coping, call us so we can talk about it.

Question 3

What should we tell a patient about eating or drinking at home in pre-labor?

Answer 3

As long as there is no contraindication for a vaginal delivery, the patient should be encouraged to continue to eat and drink. An electrolyte drink is preferable to water.

Question 4

What pain management can we recommend to a patient during pre-labor?

Answer 4

-Tylenol PM
OR
-Tylenol+Benadryl

Question 5

What lab value can be checked for dehydration/hunger?

Answer 5

Ketones

Question 6

When should you educate a patient that is discharged home when to come back in?

Answer 6

-More intense or consistent contractions
-LOF (esp if it is green)
-Significant vaginal bleeding (spotting is normal)
-Not coping

Question 7

When a patient comes into triage in early labor what options can we give them?

Answer 7

-Admission for therapeutic rest
-D/C home with or without therapeutic rest
-Reassess in 2-4 hours

Question 8

What options do we have for therapeutic rest?

Answer 8

Morphine, benadryl, ambien, vistaril, phenergan, stadol

Depending on the hospital, a patient may be given these and discharged home