Sim Lab

Question 1

What is SBAR communication?

Answer 1

t stands for Situation, Background, Assessment, and Recommendations. The S and B provide objective data, whereas the A and R allow for presentation of subjective information. The SBAR method has been used to enhance the clarity and efficiency of communication between healthcare team members.

Question 2

What assessment data do you obtain to evaluate a laboring patient
(Stage 1: From 0-10 cm dilation)?

Answer 2

Vitals: Frequency of assessment

Latent

BP, respirations q 1 hr if in normal range

Temperature q 4 hrs (unless over 37.5C [99.6F] or membranes ruptured, then q 1 hr)

Assess contractions q 15-30 min

Fetal heart rate (FHR) q 30 min (for low-risk women) or q 15 min (for high-risk women) if normal characteristics present (presence of variability, baseline in 110-160 beats/min range, without late decelerations)

Note fetal activity

Assess for reactive non-stress test if electronic monitor in place

Active

BP, pulse, respirations q 1 hr if in normal range

Palpate contractions q 15-30 min

FHR q 30 min (for low-risk women) or q 15 min (for high-risk women) if normal characteristics present

Transition

BP, pulse, respirations q 15-30 min

Palpate contractions at least q 15-30 min

FHR q 15-30 min if normal characteristics present

Question 3

What assessment data do you obtain to evaluate a laboring patient? (stage 2: 10 cm to delivery)

Answer 3

Stage 2: 10cm to Delivery

Vitals: Frequency of assessment

BP, pulse, respirations every 5-15 minutes, depending on risk factors

Some protocols recommend assessment after every contraction

Assess fetal heart rate (FHR) every 5-15 minutes, depending on risk factors

Palpate uterine contractions continuously

Question 4

What assessment data do you obtain to evaluate a laboring patient? (Stage 3: Birth of fetus to the delivery of the placenta)

Answer 4

Vitals: Frequency of assessment

• Continue to routinely monitor mother’s vitals while also allowing private time for bonding with the newborn
• Monitor newborn vitals and perform Apgar assessment at 1 min and 5 min post-birth

Question 5

What assessment data do you obtain to evaluate a laboring patient? (Stage 4: Time from 1-4 hours after birth or until VS stable)

Answer 5

Blood Pressure (should be monitored every 5-15 min)

Pulse

Fundus (uterine fundus palpated every 15 min for an hr until bleeding WNL)

Lochia

Bladder

Perineum

Emotions

Lower extremity sensation