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A Look at Malignant Hyperthermia
Malignant hyperthermia (MH) is a life-threatening syndrome associated with an anesthetic trigger. Awareness of MH by all perioperative team members, from those working in the preoperative holding area to those in the Post Anesthesia Care Unit (PACU), is important in preventing negative patient outcomes.
Define risk factors for MH and preventive measures for improving patient outcomes.
Identify the signs and symptoms of MH along with diagnostic and genetic considerations.
Describe the best practices for managing and treating MH.
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.
Anesthesia: Perioperative
The perioperative nurse plays a primary role in the anesthesia experience. Knowledge of techniques, patient assessment, and care management for the patient receiving or recovering from anesthesia positively impacts patient outcomes. This course discusses anesthetics and adjuvant medications used in the perioperative setting, anesthesia-related complications, and the nurse’s role in assisting with anesthesia management.
This course provides nursing professionals with information about the principles and practices of anesthesia care in the perioperative setting.
Identify the stages and types of anesthesia, and associated medications commonly used in the perioperative setting.
Recognize important assessment areas and nursing interventions for the perioperative patient receiving or recovering from anesthesia.
Describe complications of anesthesia and their treatments.
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.
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.
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
This course is intended to review the identification and management of various fetal heart rate patterns in a clinical context to prevent or address potential physiologic stress imposed on the fetus during labor, as evidenced by the fetal heart rate tracing.
Consistently apply National Institute of Child Health and Human Development (NICHD) definitions when describing intrapartum FHR patterns.
Recognize the importance of clinical context, FHR pattern evolution or trend, and stage of labor when managing a Category II tracing.
Identify the importance of the evolution of FHR variability when assessing the FHR pattern.
Introduction to Fetal Heart Monitoring
This course provides an introductory overview of intrapartum fetal monitoring, including the maternal-fetal oxygenation pathway, assessing uterine activity, and recognizing, interpreting, and managing FHR patterns.
Define the characteristics of FHR and uterine activity obtained via auscultation, palpation, and EFM methods.
Interpret electronic FHR and uterine patterns.
Recall key physiological and anatomical aspects of maternal-fetal circulation and select risk management strategies related to fetal monitoring.
Maternal Hemorrhage in the ED
This is a brief review of how nurses and providers should address maternal hemorrhage in the ED. All emergency departments must be prepared for obstetric hemorrhage, which can cause severe issues or death.
Recognize signs of maternal hemorrhage in the ED.
Recall the management of maternal hemorrhage in the ED.
Maternal Obesity: Mortality and Treatment Focused Care
Maternal obesity has significant implications for both the parent and fetus. This course discusses the risks associated with maternal obesity, updated care guidelines regarding BMI, and maternal, fetal, and neonatal complications associated with increased morbidity and mortality risk. You will also learn about how biases and perceptions related to BMI can affect the quality of care that patients receive and patient outcomes. Strategies to mitigate these risks through interprofessional care involving providers, nurses, and RDNs will also be reviewed.
Recognize how biases and perceptions associated with BMI and maternal obesity can affect patient care and outcomes.
Recall updated guidelines regarding BMI and maternal obesity-related complications for the patient, fetus, and neonate.
Identify interprofessional healthcare team approaches for mitigating maternal obesity-related morbidity and mortality.
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.
Neonatal Resuscitation
Neonatal emergencies are frightening and challenging to almost all acute care providers. This course will focus on the neonate and provide a succinct review of resuscitation issues pertinent to clinical practice and board preparation/review.
Understand the role of thermoregulation in neonatal distress and instability.
Recognize and interpret relevant monitoring studies for neonates in distress.
Plan the key steps and recognize the complications associated with performing neonatal resuscitation.
Plan the key steps and know the pitfalls in the prevention and management of meconium aspiration.
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.
Obstetric Medical Emergencies: Category III FHR Tracing Management
This course is intended to provide a summary of the key nursing interventions and considerations when caring for a laboring patient who is experiencing Category III FHR patterns. Whereas this may not be a daily occurrence, it is important for the labor and delivery nurse to refresh their knowledge of this critical situation, as well as have a source for quick reference in the future. This promotes ongoing efforts to maintain the highest levels of patient safety and care.
Select appropriate management interventions to respond to a Category III tracing.
Obstetric Medical Emergencies: Delayed Postpartum Hemorrhage
This course is intended to provide a summary of the key nursing interventions and considerations when caring for a patient who has a delayed postpartum hemorrhage. Whereas this may not be a daily occurrence, it is important for the postpartum nurse to refresh their knowledge of the critical situation, as well as have a source for quick reference in the future. This promotes ongoing efforts to maintain the highest levels of patient safety and care.
Recall the factors indicating increased risk for the development of a delayed PPH.
Recognize, prevent, and assess secondary PPH.
Determine management strategies and interventions for delayed PPH.
Obstetric Medical Emergencies: Eclampsia
This course is intended to provide a summary of the key nursing interventions and considerations when caring for a pregnant patient with eclampsia. Whereas this may not be a daily occurrence, it is important for the labor and delivery and postpartum nurse to refresh their knowledge of this critical situation, as well as have a source for quick reference in the future. This promotes ongoing efforts to maintain the highest levels of patient safety and care.
Identify key nursing interventions during and after eclamptic seizure.
Recall the warning signs and typical presentation of eclamptic seizure.
Obstetric Medical Emergencies: Hypertensive Diseases of Pregnancy
This course is intended to provide a summary of the key nursing interventions and considerations when caring for a pregnant patient who has severe hypertension. It is important for the labor and delivery and postpartum nurse to refresh their knowledge of the critical situation, as well as have a source for quick reference in the future. This promotes ongoing efforts to maintain the highest levels of patient safety and care.
Describe the signs and symptoms indicating increased risk for severe hypertension during pregnancy.
Identify key nursing interventions during and after delivery for a patient with severe hypertension in pregnancy.
Perioperative Series: Emergencies in the OR
Perioperative providers can BEST prepare for emergencies in the operating room by knowing the responsibilities of each team member and rehearsing interventions ahead of time. When you are in the moment and your heart is racing, it’s easy to forget how to respond or even where supplies are located. Practicing your responsibilities and team interventions ahead of time will help to prepare you for the unexpected. This course provides you with an opportunity to participate in five emergency scenarios to test your knowledge. Time is of the essence when an emergency happens so you must think and act fast to save the patient!
The goal of this course is to equip nurses and STs with knowledge of the responsibilities of the team during a range of OR emergencies.
Recognize evidence-based strategies for treating and preventing a range of OR emergencies.
Describe the roles and responsibilities of members of the surgical team when emergencies occur.
Recall the best practices for improving patient outcomes during an emergency.
Perioperative Specimen Handling
Proper surgical specimen handling is essential for patient safety. This course covers best practices for intraoperative personnel to prepare, label, and transfer specimens accurately. Adhering to these protocols ensures that specimens are identified and handled appropriately, minimizing the risk of harm to the patient.
This course provides OR nurses and surgical technologists with knowledge of best practices for specimen handling.
Describe the considerations and methods of preparing specimens for various pathologic and examination types.
Recall care standards for the appropriate handling, labeling, and transportation of specimens.
Identify common mistakes made during specimen management and prevention methods to avoid these errors.
Postpartum Hemorrhage Management
Worldwide, postpartum hemorrhage (PPH) accounts for high rates of maternal morbidity and mortality. Early recognition is key to good outcomes. Recognizing PPH, its stages, and how to measure blood loss is essential since treatment is based on the stages of hemorrhage. Additionally, it is important to understand nursing interventions, treatments for PPH, and teamwork and communication needs to improve perinatal outcomes.
This course aims to enhance the knowledge of acute care nurses about postpartum hemorrhage, including its causes, risk factors, and medical and surgical management.
Identify the causes and risk factors for postpartum hemorrhage.
Indicate the stages of postpartum hemorrhage.
Recall nursing and medical interventions used during the management of postpartum hemorrhage.
Septic Joint: Diagnosis and Treatment
Septic arthritis is caused by infection and inflammation in the joint and can result in significant damage to the joints. Early recognition and treatment are critical to the preservation of joint function. This course will discuss how to quickly identify and treat septic arthritis.
The goal of this course is to provide physicians, nursing professionals, and radiologic technologists with information about septic arthritis.
Recall how septic arthritis is acquired and its typical presentation.
Identify the laboratory and radiological tests used to make a diagnosis of a septic joint.
Recognize the principles of septic joint treatment.
Shoulder Dystocia in the ED
Shoulder dystocia is an obstetric emergency. To prepare for this rare occurrence, your healthcare team should be knowledgeable about the risk factors, potential complications, and the management of shoulder dystocia. In addition, emergency professionals should develop strategies to help their healthcare team prepare for this rare event.
Identify the risk factors, potential complications, and interventions of shoulder dystocia.
Recall strategies to prepare your healthcare team for a shoulder dystocia emergency.
Shoulder Dystocia: Management and Prevention
Nearly half of all cases of shoulder dystocia occur in the absence of risk factors, making them largely unpredictable and unpreventable. Perinatal morbidity and mortality rates associated with shoulder dystocia are high, even when properly managed.
Although shoulder dystocia is considered an obstetric emergency, a well-trained obstetric provider and a team of nursing/resuscitation professionals can usually manage it well for the pregnant person and fetus.
Identify diagnosis criteria, risk factors, and complications associated with shoulder dystocia.
Recall management and prevention techniques for shoulder dystocia.
Indicate documentation needed following a birth involving shoulder dystocia.
Shoulder Dystocia: Primary Maneuvers
A review of clinical judgment related to the use of primary maneuvers for managing shoulder dystocia.
Identify the clinical signs of shoulder dystocia and appropriate initial interventions to resolve the complication safely.
Recall risk factors for shoulder dystocia and appropriate tasks to perform following the emergency.