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.

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.

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.

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.

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.

The goal of this course is to educate nurses and physicians about key social determinants of health (SDOH) and health disparities affecting maternal and fetal outcomes.

The management of the female who presents to the emergency department (ED) in active labor is stressful and overwhelming. Ideally, the ED has a plan in place, based on hospital resources, for the imminent delivery of a newborn. Decisions regarding delivery in the ED or transferring the patient to labor and delivery are based on a variety of factors. Knowledge of the possible complications of delivery will provide anticipatory guidance to improve maternal and fetal outcomes.

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.

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. 

As the population of the U.S. soars in diversity, healthcare professionals must be prepared to care for childbearing families from many different cultures. All cultures and families should be given the same respect, be assured of the highest quality of care, have their religious, ethnic, and cultural values respected and integrated into their care, and have their physical and educational needs met in a way that honors their spiritual beliefs and individuality. Knowledge of the cultures one is serving and the influence they have on women’s perceptions of childbirth are important for achieving positive outcomes. Equally and perhaps more important is applying the principles of cultural humility to nursing care.

The goal of this continuing education course is to improve the ability of nurses and health educators in acute care settings to assess and meet the sociocultural needs of childbearing families of diverse cultural and social groups. 

Healthcare professionals often feel unprepared to ask about abuse or to counsel a pregnant woman who is being abused, although they are in a unique position to assess for IPV and to support women who experience it. As such, it is necessary for clinicians to skillfully screen for IPV and offer effective interventions when appropriate.

In this course, you will learn about pediatric anatomical and physiological differences, which will help you recognize normal variations throughout your assessment. Additionally, you will learn communication methods to help children feel more at ease during your assessment. Finally, you will understand essential warning signs that require immediate referral to additional medical professionals using the available resources and tools.

Americans are using opioids at an alarming rate, whether through prescriptions or illegal means. Parallel to this problem is the use of opioids during pregnancy.

The goal for this course is to present RNs, PAs, physicians, and entry-level drug and alcohol counselors in inpatient or outpatient settings with best practices for identifying and managing pregnant women who are using opioids.

Perioperative professionals must have a fundamental understanding of the anatomical, physiological, psychological, and emotional differences of children compared to adults and how these differences impact the care needs of pediatric patients in the perioperative period.

The Certified Emergency Nurse (CEN®) is required to demonstrate competency in the domain of emergency nursing which includes knowledge of gynecological and obstetrical conditions and diseases, their signs and symptoms, management, and applicable nursing interventions.

Concussion is a form of mild traumatic brain injury that is common in children and adolescents. Despite increased awareness about the injury, concussion remains under-reported and under-diagnosed. Nurses and Radiology Technicians must be aware of the identification, diagnosis, and management of concussions in pediatric patients. 

The Emergency Medical Treatment and Active Labor Act (EMTALA) was enacted to prevent patient dumping by hospitals seeking to avoid unrecoverable costs of care for patients without insurance or the ability to pay for medical services. Language within the statute has led to inconsistencies in how it has been interpreted. Patient dumping and inappropriate medical screening examinations (MSEs) are the most common reasons for EMTALA violations (Ladd & Gupta, 2021). This course will describe how key terms are currently interpreted and how they apply to hospitals with a dedicated emergency department (ED). In addition, learners will have an opportunity to review cases where EMTALA violations were alleged and judgments applied by the courts. 

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.  

Pain is often underestimated and undertreated in the pediatric population due to many factors. As a result, children’s health outcomes are directly impacted without proper recognition and pain management, and quality of life is reduced. Physicians and nursing professionals must learn to assess and treat pediatric pain appropriately while caring for hospitalized children. This course describes the past and future status of pain management in children, pharmacological and non-pharmacological management options, and the complexities of managing pain in special populations.

This course is intended to provide nurses with knowledge on interventions for pediatric trauma, including injuries to the head, chest, abdominal cavity, and extremities. Interventions for asphyxiation, drowning, burns, and electrical shock will also be presented. This course is the second part of the Managing Pediatric Trauma series. The first course in this series is Managing Pediatric Trauma: Assessment.

This course is intended to provide nurses with knowledge of pediatric stages of development, mechanisms of injury, and assessment best practices including the pediatric assessment triangle as they relate to trauma.

Worldwide, postpartum hemorrhage (PPH) accounts for high rates of maternal morbidity and mortality. It is important to understand the definitions and causes of PPH, as well as the many risk factors associated with PPH and how to assess a woman’s risk. Early recognition is key to have good outcomes. Recognizing PPH, the stages of PPH, and how to measure blood loss is essential, since treatment is based upon the stages of hemorrhage. Additionally, it is important to understand nursing interventions, treatments for PPH (including medication, surgical procedures, and blood products), and teamwork and communication needs to improve perinatal outcomes.

Nurses, respiratory therapists, and emergency medical professionals who care for children must have the requisite skills and training on the unique characteristics of a pediatric patient’s respiratory system. Children have significant respiratory system differences compared to adults. These include, but are not limited to: Anatomy, physiology, signs and symptoms of respiratory distress, and respiratory emergencies. In children, the leading cause of cardiopulmonary arrest occurs from etiologies within the respiratory system. Clinicians must understand these differences and be prepared to work collaboratively to quickly respond and provide safe and competent care to any child who is in respiratory distress.

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.