9/11/2019 Feedback Log & Score — Carla Hernandez 

Sept 11, 2019 8:03 PM

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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Score
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100%
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Feedback Log
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0:00 You arrived at the patient.

0:00 You introduced yourself.

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.

0:12 You washed your hands.

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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
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heart rate: 68.

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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
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heart rate: 88.

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2:32 You assisted the patient into Trendelenburg position.

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.

2:43 You turned the oxygen on.

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2:55 You phoned the provider in order to discuss the patient.

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.

4:30 You asked if the patient was <Allergy>allergic<> to anything. She

replied: 'No, I am not allergic to anything.'
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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.

4:43 You administered 0.25 mg of terbutaline subcutaneously. It is important to use

the basic rights of medication administration to ensure proper drug therapy. This
was indicated by order.

4:59 You called the surgery unit.

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.

5:20 The electronic fetal monitor showed a late deceleration.

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:
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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
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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.

8:11 You witnessed the patient's signature on an informed consent.

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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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heart rate: 105.

9:27 The electronic fetal monitor showed a late deceleration.

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.

9:52 The infusion of lactated Ringer's solution was stopped.

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.

10:30 You measured the <Bloodpressure>blood pressure<> at 140/82 mmHg.

It is appropriate to monitor the patient by measuring the blood pressure.

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.

10:55 You checked the <Temperature>temperature<> at the mouth. The

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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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You got 100%

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