In patients with symptoms of acute stroke, early recognition and interventions have been identified as critical factors in stroke outcomes. Evidence-based care can identify, manage, and prevent stroke-related complications. Nurses and physicians must understand stroke management to prevent disability and death. This course aims to present the most up-to-date practices for managing patients with acute stroke.

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.

The goal of this course is to provide nurses and prescribing providers (physicians) in all healthcare settings with best practices to improve their care team approach to patients with depression and anxiety.

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.

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 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.

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.

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. 

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.

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. 

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.

The goal of this course is to provide addictions, behavioral health counseling, marriage and family therapy, nursing, psychology, and social work professionals in health and human service settings with information about how substance use disorders can impact family systems and approaches to help the family system. 

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.

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. 

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.

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.

The goal of this course is to provide the clinician with up-to-date best practices for identifying and treating patients with PAD. It includes symptoms, complications, risk factors, and modifications of PAD. In addition, diagnostic tests, assessment, and treatment strategies will be discussed.

Alcohol use disorder is a primary health condition that interacts with and complicates many other health problems and psychiatric disorders. Unfortunately, only a small number of people with alcohol use disorder receive appropriate treatment for substance use issues. The incorporation of screening for alcohol use disorders in a general medical setting can significantly increase the number of individuals with alcohol use disorders who are identified and treated. The U.S. Food and Drug Administration (FDA) has approved 4 medications to treat alcohol use disorder, making treatment in primary care and other general medical settings a viable alternative to specialty care. This course will give you valuable information about these medications as well as several medications used off-label.

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.
 

This course is designed to provide nursing professionals with a comprehensive understanding of the NIH stroke scale. The course will cover the purpose of the NIH stroke scale, how to administer the scale, and how to interpret the results. The course will also include case studies that illustrate the use of the NIH stroke scale in clinical practice.

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.

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.