Rupture of Membranes: Assessment (Nursing)

00:01 So we've talked a little bit about discharge and leaking membranes and things like that.

00:07 So let's look a little bit more into how we assess for this.

00:11 So there are several ways and several procedures that we can use to figure out if someone is actually experiencing rupturing of the membranes, or releasing of the membranes depending on the words that you want to use.

00:22 The first one is a Fern test, and that's what you see in this first graphic.

00:27 So what happens is we take a little bit of sample of the discharge, and we put it on a microscope slide without the cover slip, we let it dry, and it shows a fern pattern.

00:37 And so that's what we see under the microscope.

00:40 The next one, this is actually a graphic of a speculum inside the vagina.

00:45 And we can actually see the fluid as it comes from the cervix, we can see it in the blades of the speculum, and that's called 'pooling'.

00:53 We may also just see a lot of discharge.

00:56 They like to make fun of this on TV shows a lot when someone's membranes will rupture, and it'll be all over the floor or in a restaurant or someplace very dramatic.

01:06 It's not usually that dramatic, but often it is a lot of discharge.

01:10 The final way that we may be able to assess for ruptured membranes is called a nitrazine test.

01:15 Now, you might remember this from biology, we would use little slips of paper and we would put it in a certain substance, and it would turn blue or yellow or green, depending on what the pH might be.

01:25 And so with nitrazine paper, we actually take a little piece of that and put it into the fluid and if it turns blue, guess what? It's positive for ruptured membranes.

01:37 Alright, now, we want to do a few questions to see if we are still on track.

01:42 So I'm going to read the question to you, give you a second to think of the answer and then we'll go over that.

01:47 So here's the first question.

01:48 Which of the following assessment findings is consistent with a patient who is experiencing ruptured membranes? We just did that so think for a moment.

01:57 Now here are our options.

01:59 A yellow result on a nitrazine test, a large mass of bloody mucus, a positive fern test, or a positive fetal fibronectin test.

02:15 That's right, a positive fern test.

02:18 So remember the graphic, remember, no cover slip, we let it dry and we get a fern.