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Clinical Management of Category III Fetal Heart Rate Tracings
The National Institute of Child Health and Human Development (NICHD) workgroup standard for fetal heart rate monitoring assessment and categorization, first proposed in 1997 and subsequently updated in 2008 was meant to promote commonality of FHR tracing nomenclature and interpretation. Based on these recommendations, a three-tiered categorization pattern based on the visual assessment of the fetal heart rate pattern was adopted. This module aims to review and apply essential FHR content in several clinical scenarios to highlight an important Clinical Pearl: The Category III tracing is a rare intrapartum FHR pattern that is highly associated with fetal acidemia and adverse neonatal outcomes.
Consistently apply 1997 and 2008 NICHD definitions and terminology when describing intrapartum fetal heart rate patterns.
Identify intrapartum fetal heart rate tracings using the 2008 NICHD 3-tiered system.
Recognize the fetal heart rate characteristics that define a Category III pattern.
Review the diagnostic imprecision and clinical significance of minimal fetal heart rate variability.
Care Teams: Depression and Anxiety
The goal of this course is to provide nurses and prescribing providers (physicians) in all healthcare settings with best practices to improve their care team approach to patients with depression and anxiety.
Recall care team best practices, including collaboration, communication, and roles.
Identify how care team best practices can improve outcomes for patients with depression and anxiety.
An Overview of Trial of Labor After Cesarean Section
This course provides an overview about the safety of patients undergoing a trial of labor after cesarean (TOLAC) to attempt a vaginal birth after cesarean delivery (VBAC). Research evidence has influenced where VBACs are performed, which women are eligible and how the practice is conducted, including the safe use of induction/augmentation medications. The safety of VBAC for mother and newborn always remains the primary underlying principle that guides care.
Identify three risk factors and benefits associated with TOLAC and recommendations for safe TOLAC.
Recall essential components of nursing education, informed consent, safe medication administration, and fetal assessment related to TOLAC.
Clinical Management of Uterine Atony
A case of obstetrical hemorrhage due to uterine atony, requiring medical and surgical interventions and blood component replacement therapy is presented. Emphasis: A review of obstetrical hemorrhage, etiologies, and treatments is provided. The importance of early recognition and response to excessive blood loss is stressed. Medical and surgical interventions for uterine atony are reviewed. Current recommendations for blood component replacement therapy for massive hemorrhage are discussed.
List common risk factors for OH.
Review medical treatments for uterine atony.
Identify pre-surgical and surgical treatments for uterine atony.
Describe blood component therapy for massive hemorrhage.
Fetal Heart Tracing Pattern Evolution
Intrapartum fetal heart rate monitoring is an integral part of modern day obstetrics and when properly interpreted, may provide valuable insight into the fetal metabolic state. During labor, the physiologic stress posed by regular uterine contractions and maternal expulsive efforts may adversely impact the fetal acid-base status, leading to changes in the fetal heart rate pattern.
This module aims to review and apply essential FHR content in several clinical scenarios to highlight an important Clinical Pearl: Management of the laboring patient requires that the FHR pattern trends are interpreted in context with the clinical scenario and progress of labor.
Consistently apply 1997 and 2008 NICHD definitions when describing intrapartum fetal heart rate patterns.
Identify the importance of FHR variability evolution when assessing the FHR pattern.
Review the importance of FHR tracing trend assessment when managing the abnormal intrapartum FHR tracing.
Recognize the importance of clinical scenario, FHR pattern evolution, and stage of labor when managing the Category II tracing in labor.
Obstetric Hemorrhage: Mitigating Risk to Improve Outcomes
Two cases are presented. Risk factors, including recurring and nonrecurring, for obstetrical hemorrhage, are reviewed. Delivery preparations and preventative strategies are discussed. Methodologies that better quantify blood loss, allowing for earlier recognition of excessive blood loss, are presented. Management of the patient experiencing obstetric hemorrhage, including a review of current guidelines for blood component replacement therapy, are reviewed.
List recurring and nonrecurring risk factors for obstetrical hemorrhage. List the four Ts of OH.
Identify low, medium and high risk patients for OH.
Review blood component therapy for large volume blood loss.
Shoulder Dystocia: Teamwork and Training
This content is intended for all members of the obstetric team and is based on the educational theory that team performance is enhanced when all members of the team have the same understanding of the task and procedure to be performed.
Enhance situational awareness for patients at increased risks for shoulder dystocia (SD). Design a team-based SD simulation drill. Improve obstetrical team performance through enhanced cooperation in deliveries complicated by SD. Review methods to enhance communications with teams.
Clinical Management of Category II Fetal Heart Tracing
Three different obstetrical scenarios, complicated by a Category II Fetal Heart Rate pattern, are presented to illustrate the importance of clinical context when formulating management plans. Emphasis, characteristics, and potential etiologies of Category II fetal heart rate tracings are reviewed. Management of the patient with a Category II fetal heart rate pattern is discussed, with special emphasis on the importance of the clinical context and fetal heart rate pattern evolution.
Describe characteristics of Category II FHR tracings.
Identify common etiologies for Category II FHR tracings during labor.
Examine clinical interventions for Category II FHR tracings.
Review the etiology-based management of Category II FHR tracings.
A Review of Traumatic Brain Injury (TBI)
A traumatic brain injury (TBI) is a complex condition that may have short- or long-term effects on a patient. TBIs have a wide array of associated symptoms and disabilities. These may have a significant impact on the lives of patients and their families. Healthcare professionals should be ready to rapidly assess patients with TBIs so that they can be treated promptly.
This course provides strategies to enhance the knowledge and skills of physicians, registered nurses, and physician assistants in recognizing, assessing, and managing traumatic brain injuries, contributing to improved patient outcomes and interdisciplinary collaboration.
Indicate how to assess and diagnose traumatic brain injuries, using both clinical examination and diagnostic tools, recognizing the signs and symptoms that distinguish mild, moderate, and severe TBI.
Apply management strategies for TBI, including immediate interventions, pharmacological treatments, and monitoring techniques, to optimize patient care from acute to rehabilitative stages.
Discuss the importance of using a multidisciplinary approach in the management of TBI to support recovery, minimize complications, and facilitate patient and family education.
Managing Coagulopathies
The focus of this course is coagulopathies. In general, the term coagulopathy refers to bleeding disorders. This course will provide a review of the components of a clot. It will also provide you with valuable information about how to care for those with coagulopathies such as immune thrombocytopenia (ITP), disseminated intravascular coagulopathy (DIC), heparin-induced thrombocytopenia (HIT), and warfarin-induced coagulopathy.
The goal of this course is to provide nurses in the critical care setting with a general overview of coagulopathies, including the recognition and nursing management of ITP, DIC, HIT, and warfarin-induced coagulopathy.
Describe the etiology and presentation of DIC, ITP, HIT, and warfarin-induced coagulopathy.
Identify proper nursing care for those with DIC, ITP, HIT, and warfarin-induced coagulopathies.
Identify emergency findings in those with coagulopathies and discuss the appropriate nursing interventions.
Recognizing and Treating Stroke
By understanding the causes of stroke and how to treat and prevent it, you can make a significant difference in the lives of those you care for. This course will help you identify the symptoms of a stroke and provide you with the necessary knowledge to provide care during and after the stroke.
Recall the pathophysiology of a stroke.
Recognize at least three interventions for someone experiencing a stroke.
Identify strategies for achieving quality of life after a stroke.
Acute Heart Failure
Heart failure (HF) treatment is costly and requires a multidisciplinary approach. Evidence-based treatment guidelines improve patient outcomes, and it is essential to become familiar with these guidelines to reduce patient mortality. Healthcare team members play a significant role in treating acute HF (AHF), helping to reduce the morbidity and mortality of the disease and decrease the use and costs associated with care. This course aims to educate nurses and nutrition and dietetics professionals in the acute care setting about evidence-based heart failure treatment guidelines.
Describe heart failure, including its classification systems, presentation, treatment, and evidence-based therapies.
Describe strategies for patient self-management.
Acute Stroke and the Latest Information
In patients with symptoms of acute stroke, early recognition and interventions have been identified as critical factors in stroke outcomes. Evidence-based care can identify, manage, and prevent stroke-related complications. Nurses and physicians must understand stroke management to prevent disability and death. This course aims to present the most up-to-date practices for managing patients with acute stroke.
Discuss current diagnostic practices in patients with acute stroke.
Recall best practice protocols for early identification of acute stroke.
Stroke: Recognition and Management
This course equips healthcare professionals with essential knowledge and skills to promptly and effectively manage stroke in the acute care setting. Participants will gain insight into how to recognize an acute stroke and the initial steps to take for emergency treatment of stroke. In addition, learners will know the different acute treatment options for ischemic and hemorrhagic stroke as well as patient care for acute stroke.
Recall the benchmark diagnosis and treatment times for acute stroke.
Differentiate the treatment of ischemic stroke and hemorrhagic stroke.
Indicate interventions in the care of a patient presenting with an acute stroke.
NIH Stroke Scale
This course is designed to provide nursing professionals with a comprehensive understanding of the NIH stroke scale. The course will cover the purpose of the NIH stroke scale, how to administer the scale, and how to interpret the results. The course will also include case studies that illustrate the use of the NIH stroke scale in clinical practice.
Identify the purpose of the NIHSS and how it is used in clinical practice.
Recall the significance of NIHSS scores to patient outcomes.
Apply the NIHSS to assess patients with stroke or stroke-like symptoms including how to score each section of the NIHSS.
Managing Peripheral Artery Disease
The goal of this course is to provide the clinician with up-to-date best practices for identifying and treating patients with PAD. It includes symptoms, complications, risk factors, and modifications of PAD. In addition, diagnostic tests, assessment, and treatment strategies will be discussed.
Identify risk factors and complications related to PAD.
Discuss two assessment findings and tools used to diagnose PAD.
Describe two disease management and education techniques for patients with PAD.
Assessment and Treatment of Depressive Disorders in Children & Adolescents
In this course, you will learn to identify different depressive disorders, as well as the unique ways depression manifests in children and adolescents. Additionally, you will learn to recognize risk factors for both depression and suicidality in youth.
An integrated care model treats the whole child by combining primary care and mental healthcare in one setting. Within this model, treatment providers understand how to screen for depression and suicidality in order to coordinate care. You will learn about specific instruments useful for detecting depression and suicidality among youth. An understanding of the root causes of depression will highlight the rationale for various treatment approaches. Lastly, you will be able to describe the best practices available to help children and adolescents manage depression.
Identify three different types of depressive disorders and common symptoms of depression in children and adolescents.
Identify at least five causes and risk factors of clinical depression and how to screen for depressive disorders in children and adolescents.
Describe three interventions to treat child and adolescent depressive disorders.
Medical Management of Operative/Assisted Vaginal Delivery
This course discusses best practices in operative vaginal delivery techniques—forceps-assisted delivery and vacuum-assisted delivery (OAVD), as well as episiotomy.
The course is case-based, so you will have an opportunity to apply the principles covered to particular patient scenarios. The cases are branched, with different outcomes based on different choices.
Use of OAVD techniques vary from organization to organization. You may, for example, work in a hospital in which forceps techniques are no longer taught to residents. Each section has been organized so that you can move through it quickly or delve into it more deeply, depending on its relevance to your clinical practice.
Discuss the steps, indications, contraindications, and potential complications associated with vacuum-assisted vaginal delivery, forceps-assisted vaginal delivery, and episiotomies.
Describe the circumstances in which an episiotomy is and is not an appropriate intervention.
Explain the importance of the flexion point when placing a vacuum cup and how it is located. Identify the criteria for correct placement of the forceps during a non-rotational delivery, as well as guidelines regarding the number of pulls.