MCN. The American journal of maternal child nursing
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MCN Am J Matern Child Nurs · Jan 2009
ReviewCaring for the extremely obese woman during pregnancy and birth.
This article describes the special care needed by the pregnant woman who is extremely obese. Many pregnant women who are extremely obese have underlying medical conditions, and a multidisciplinary, coordinated approach to their care involving anesthesia providers, physicians, and the nursing staff is needed to develop a detailed plan for vaginal and cesarean births. Such an approach, begun preconceptionally or during pregnancy, can enable care to be delivered smoothly and safely and should include an evaluation of the unit's equipment and furniture to determine if they are appropriate for obese persons. Equipment that should be evaluated for size and weight limits include beds, operating room tables, commodes, wheelchairs, scales, walkers, blood pressure cuffs, transfer devices, and intermittent pneumatic compression devices.
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MCN Am J Matern Child Nurs · Jan 2009
Oxytocin as a high-alert medication: implications for perinatal patient safety.
Patient injury from drug therapy is the single most common type of adverse event that occurs in the in-patient setting. When medication errors result in patient injury, there are significant costs to the patient, healthcare providers, and institution. Some medications that have a heightened risk of causing significant patient harm when they are used in error are called "high-alert medications."In 2007, the Institute for Safe Medication Practices added intravenous (IV) oxytocin to their list of high-alert medications. ⋯ Other types of oxytocin errors involve mistaken administration of IV fluids with oxytocin for IV fluid resuscitation during nonreassuring (abnormal or indeterminate) fetal heart rate patterns and/or maternal hypotension and inappropriate elective administration of oxytocin to women who are less than 39 completed weeks' gestation. Oxytocin medication errors and subsequent patient harm are generally preventable. The perinatal team can develop strategies to minimize risk of maternal-fetal injuries related to oxytocin administration consistent with safe care practices used with other high-alert medications.