Module 6 BBB First Stage Management

Question 1

Your term multip patient was admitted for labor at 5-6cm and 0 station. Her membranes are intact. She states she had her membranes ruptured with her previous delivery. What additional data should you collect before AROM?

Answer 1

Fetal presentation, eligibility for a vaginal delivery, route of previous delivery, pain level and coping status, plan for pain management, category FHR, evaluation contraction pattern, and strength with palpation, review patients understanding of AROM, GBS status

Question 2

What can we tell a patient about the risks and benefits of AROM in active labor?

Answer 2

Benefit: expedites delivery by 30 minutes
Risks: Infection, cord prolapse, intolerance of FHR, increased pain with contractions

Question 3

Should we recommend AROM for a actively laboring multip who is requesting it “because it was done last time”?

Answer 3

Recommend against because the risks outweigh the benefits but should use shared decision making

Question 4

How often is it recommended to check vital signs on a laboring patient?

Answer 4

VS every hour and temp every 1-2 hours

Question 5

What are our options for monitoring with fetal monitoring on a cat 1 tracing low risk patient in active labor?

Answer 5

EFM or IA

Question 6

How often should we IA in active labor?

Answer 6

q15-30 min in active labor

Question 7

What can we tell our patient about eating and drinking in active labor?

Answer 7

Whatever she can tolerate to eat and drink is fine

Question 8

What recommendations for pain relief are available for labor?

Answer 8

Movement, massage, TENS, hydrotherapy, counter pressure, etc.