Carla Hernandez 100
Carla Hernandez 100
Carla Hernandez 100
Date of Completion
Sept 11, 2019 8:03 PM
Carla Hernandez
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Age: 32 years
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Diagnosis: rs e
Umbilical Cord Prolapse
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aC s
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Score
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100%
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Feedback Log
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0:10 Patient status - Heart rate: 89. Pulse: Present. Blood pressure: 136/82 mmHg. Respiration:
16. Conscious state: Appropriate. SpO2: 97%. Temp: 37 C. EFM: Baseline. Fetal heart
rate: 89.
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9/11/2019 Feedback Log & Score — Carla Hernandez Sept 11, 2019 8:03 PM
0:15 The electronic fetal monitor showed a non-reassuring drop in fetal heart rate.
0:29 You identified the patient. If you are in doubt, it is always a good idea to repeat
the identification.
0:40 You provided patient education. This is correct. It is important to provide patient
educate to improve understanding of the patient's medical condition and
methodes and means to manage her condition. Effective communication and
patient education increases patient motivation to comply.
1:08 You performed a vaginal exam. This was reasonable. The umbilical cord had
prolapsed.
1:09 Patient status - Heart rate: 91. Pulse: Present. Blood pressure: 140/83 mmHg. Respiration:
16. Conscious state: Appropriate. SpO2: 97%. Temp: 37 C. EFM: Late deceleration. Fetal
heart rate: 71.
1:17 You palpated the uterus for contractions. This was reasonable. The uterus tone
was moderate between contractions. Regular contractions with moderate
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intensity had started. Contractions were approximately 4 minutes apart and
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lasting 50 seconds.
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1:24 The electronic fetal monitor showed a late deceleration.
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2:00
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You relieved pressure from the umbilical cord. This was indicated and the correct
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response to the patient's condition.
2:09 Patient status - Heart rate: 90. Pulse: Present. Blood pressure: 138/82 mmHg. Respiration:
15. Conscious state: Appropriate. SpO2: 97%. Temp: 37 C. EFM: Late deceleration. Fetal
o
2:21 You calmed and supported the patient and the family. This is reasonable.
2:23 Patient status - Heart rate: 90. Pulse: Present. Blood pressure: 138/82 mmHg. Respiration:
15. Conscious state: Appropriate. SpO2: 97%. Temp: 37 C. EFM: Late deceleration. Fetal
ed d
2:33 Patient status - Heart rate: 90. Pulse: Present. Blood pressure: 138/83 mmHg. Respiration:
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15. Conscious state: Appropriate. SpO2: 97%. Temp: 37 C. EFM: Baseline. Fetal heart
rate: 97.
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2:38 You gave the patient 100% oxygen from a nonrebreathing mask.
3:33 Patient status - Heart rate: 88. Pulse: Present. Blood pressure: 136/81 mmHg. Respiration:
15. Conscious state: Appropriate. SpO2: 98%. Temp: 37 C. EFM: Baseline. Fetal heart
rate: 105.
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9/11/2019 Feedback Log & Score — Carla Hernandez Sept 11, 2019 8:03 PM
4:33 Patient status - Heart rate: 87. Pulse: Present. Blood pressure: 136/82 mmHg. Respiration:
15. Conscious state: Appropriate. SpO2: 99%. Temp: 37 C. EFM: Baseline. Fetal heart
rate: 105.
5:05 Patient status - Heart rate: 89. Pulse: Present. Blood pressure: 140/83 mmHg. Respiration:
16. Conscious state: Appropriate. SpO2: 99%. Temp: 37 C. EFM: Late deceleration. Fetal
heart rate: 105.
5:30 Patient status - Heart rate: 92. Pulse: Present. Blood pressure: 139/84 mmHg. Respiration:
17. Conscious state: Appropriate. SpO2: 99%. Temp: 37 C. EFM: Late deceleration. Fetal
heart rate: 84.
5:36 You called the anesthesia care team and asked for assistance.
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5:45 Patient status - Heart rate: 90. Pulse: Present. Blood pressure: 140/84 mmHg. Respiration:
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16. Conscious state: Appropriate. SpO2: 99%. Temp: 37 C. EFM: Late deceleration. Fetal
heart rate: 63.
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6:21 rs e
Patient status - Heart rate: 88. Pulse: Present. Blood pressure: 137/82 mmHg. Respiration:
ou urc
15. Conscious state: Appropriate. SpO2: 99%. Temp: 37 C. EFM: Late deceleration. Fetal
heart rate: 83.
6:31 Patient status - Heart rate: 88. Pulse: Present. Blood pressure: 137/82 mmHg. Respiration:
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15. Conscious state: Appropriate. SpO2: 99%. Temp: 37 C. EFM: Baseline. Fetal heart
aC s
rate: 94.
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6:53 You called the neonatal intensive care unit and asked for assistance.
7:31 Patient status - Heart rate: 88. Pulse: Present. Blood pressure: 138/83 mmHg. Respiration:
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15. Conscious state: Appropriate. SpO2: 100%. Temp: 37 C. EFM: Baseline. Fetal heart
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rate: 104.
8:31 Patient status - Heart rate: 88. Pulse: Present. Blood pressure: 136/81 mmHg. Respiration:
15. Conscious state: Appropriate. SpO2: 100%. Temp: 37 C. EFM: Baseline. Fetal heart
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rate: 105.
9:12 Patient status - Heart rate: 90. Pulse: Present. Blood pressure: 141/83 mmHg. Respiration:
16. Conscious state: Appropriate. SpO2: 100%. Temp: 37 C. EFM: Late deceleration. Fetal
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9:27 You calmed and supported the patient and the family.
9:37 Patient status - Heart rate: 92. Pulse: Present. Blood pressure: 144/85 mmHg. Respiration:
16. Conscious state: Appropriate. SpO2: 100%. Temp: 37 C. EFM: Late deceleration. Fetal
heart rate: 84.
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9/11/2019 Feedback Log & Score — Carla Hernandez Sept 11, 2019 8:03 PM
9:51 Patient status - Heart rate: 90. Pulse: Present. Blood pressure: 142/84 mmHg. Respiration:
16. Conscious state: Appropriate. SpO2: 100%. Temp: 37 C. EFM: Late deceleration. Fetal
heart rate: 63.
9:56 You started a bolus of 500 mL of lactated Ringer's solution IV, given over
30 minutes. This was the correct response to the patient's condition.
10:29 Patient status - Heart rate: 88. Pulse: Present. Blood pressure: 137/82 mmHg. Respiration:
15. Conscious state: Appropriate. SpO2: 100%. Temp: 37 C. EFM: Late deceleration. Fetal
heart rate: 83.
10:39 Patient status - Heart rate: 87. Pulse: Present. Blood pressure: 140/83 mmHg. Respiration:
15. Conscious state: Appropriate. SpO2: 100%. Temp: 37 C. EFM: Baseline. Fetal heart
rate: 94.
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temperature was 37 C.
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11:09 You transferred the patient to surgery. This was reasonable.
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Umbilical cord prolapse is a medical emergency where critical thinking and
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prompt interventions are essential to reduce perinatal mortality. It is important for
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health care providers to identify antenatal risk factors, which may include:
unengaged presenting part, malpresentation, fetus small for gestational age, or a
longer umbilical cord. Providers must understand that umbilical cord prolapse
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may occur with spontaneous or artificial rupture of membranes when risk factors
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are present. Umbilical cord prolapse can be recognized when the cord is seen
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protruding from the vagina, when the cord is palpated during a vaginal exam, or
when abnormal fetal heart rate patterns (bradycardia or variable decelerations)
are observed. The priority action should be to relieve pressure on the umbilical
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cord. The nurse should remain calm, call for help, and prepare team and patient
for C-section.
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