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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.
CEN: Gynecological and Obstetrical Emergencies
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.
Identify signs and symptoms of gynecological and obstetrical emergencies and injuries.
Describe a comprehensive plan for the care of gynecological and obstetrical conditions including diagnostic and treatment interventions, and patient education.
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.
Cultural Perspectives in Childbearing
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.
Recall the relationship of culture, subculture, acculturation, assimilation, ethnocentrism, cultural relativism, and cultural humility to healthcare practice.
Recognize elements of cultural assessment and respectful maternity care that can improve quality of care and meet the unique needs of culturally diverse families.
Diagnostic Failure and Delayed Diagnosis in Emergency Medicine
This course examines diagnostic failure and delayed diagnosis in emergency medicine. It is designed to enhance understanding of the common causes and implications of diagnostic failures and delays and provide strategies for improving diagnostic accuracy in emergency settings.
Recognize the impact of diagnostic errors and contributing factors to diagnostic failures and delays.
Identify strategies for improving diagnostic accuracy and preventing errors and delays through interprofessional collaboration.
Emergent Delivery of Infant
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.
Know the clinical presentation and physical exam findings associated with pregnancy.
Recognize the common complications associated with pregnancy. Plan the steps to prepare the process of delivery of a newborn.
Recognize common complications of delivery of a newborn.
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.
Management of Obstetric Hemorrhage
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 Emergencies: ED Provider - Ectopic Pregnancy
This course provides an overview of ectopic pregnancies, with a focus on diagnosis and treatment options.
Definition of ectopic pregnancy.
Diagnosis of ectopic pregnancy.
Treatment of ectopic pregnancy.
Maternal Emergencies: ED Provider - Electronic Fetal Monitoring
Electronic fetal monitoring (EFM) can be crucial to stabilizing patients in the emergency department (ED). The goal of this course is to provide physicians and nursing professionals with the knowledge to meet new standards from The Joint Commission regarding fetal monitoring procedures and stabilization in the ED.
Recall how to perform electronic fetal monitoring in the ED.
Identify how to interpret and respond to electronic fetal monitoring tracings.
Maternal Emergencies: ED Provider - Hemorrhage
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 Emergencies: ED Provider - Hypertension and Preeclampsia
Hypertensive disorders are the most common medical complication affecting pregnancy and are the second leading cause of maternal deaths in the U.S. In the ED, healthcare professionals must know about hypertensive disorders in the perinatal patient population to provide safe, evidence-based care. This course will provide information about the hypertensive disorders of pregnancy, its effects on the mother and fetus, and recommended management.
Identify the risk factors, defining features, and potential adverse outcomes of the four hypertensive disorders in pregnancy.
Review the management of a patient with hypertensive disorder in the prenatal, intrapartum, and postpartum periods.
Maternal Emergencies: ED Provider - Shoulder Dystocia
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.
Maternal Emergencies: ED Provider - Umbilical Cord Prolapse
This course presents providers with a review of umbilical cord prolapse, its causes, presentation, diagnosis, and management.
List obstetric and iatrogenic risk factors for umbilical cord prolapse.
Distinguish between overt and occult umbilical cord prolapse.
Review the clinical presentation of umbilical cord prolapse.
Outline the clinical management of overt umbilical cord prolapse.
Maternal Emergencies: OB Provider - Category III FHR Tracing
This course reviews the FHR characteristics of Category III patterns, their etiologies, and clinical significance.
Identify Category III FHR tracings.
Describe the clinical significance of a Category III FHR tracing.
Outline the clinical management of the Category III FHR tracing.
Maternal Emergencies: OB Provider - Hemorrhage and Hypovolemic Shock
This course provides OB and ED providers with a review of hypovolemia in pregnancy with emphasis on early recognition, prompt resuscitation, and identification and control of the causative etiology.
Recognizing the clinical signs of hypovolemia in pregnancy.
Apply clinical screening tools to identify patients experiencing hypovolemia.
List common etiologies for hypovolemia in pregnancy.
Review clinical management of hypovolemia in pregnancy.
Maternal Emergencies: OB Provider - Sepsis Management
This course provides an overview of sepsis in pregnancy, with a focus on screening tools to facilitate early recognition and timely treatment.
Define sepsis and septic shock.
Review sepsis screening tools used in pregnancy.
Review common etiologies for sepsis in pregnancy.
Review treatment approach to sepsis, sepsis bundle.
Maternal Emergencies: OB Provider - Umbilical Cord Prolapse
This course provides a review of umbilical cord prolapse, its causes, presentation, diagnosis, and management.
List obstetric and iatrogenic risk factors for umbilical cord prolapse.
Distinguish between overt and occult umbilical cord prolapse.
Review the clinical presentation of umbilical cord prolapse.
Outline the clinical management of overt umbilical cord prolapse.
Maternal Emergencies: OB Provider - Uterine Rupture
This course reviews common risk factors and clinical features of uterine rupture to enhance early recognition and timely delivery, emphasizing diagnosis and treatment.
Define risk factors for uterine rupture.
Identify the most common signs and symptoms of uterine rupture.
Recall prevention and response measures for uterine rupture.
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.