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    OB Case Study 1

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    Sdv
    1. The nurse is asked to take Ms. AB, who is having contractions, to an intake room to determine the next steps in her care. The nurse will ask Ms. AB three initial questions and calculate her approximate date of gestation and estimated due date based on her last period. 2. Upon examination, Ms. AB is 80% effaced and 6 cm dilated with a regular fetal heart rate of 152 beats per minute. She will be admitted to the labor room and monitored, and alternative therapies will be used for her discomfort before medication. 3. Later, late decelerations of the fetal heart rate are noticed during contractions after Ms. AB receives pain medication. Actions will be taken to monitor

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    OB Case Study 1

    Uploaded by

    Sdv
    96 views2 pages
    1. The nurse is asked to take Ms. AB, who is having contractions, to an intake room to determine the next steps in her care. The nurse will ask Ms. AB three initial questions and calculate her approximate date of gestation and estimated due date based on her last period. 2. Upon examination, Ms. AB is 80% effaced and 6 cm dilated with a regular fetal heart rate of 152 beats per minute. She will be admitted to the labor room and monitored, and alternative therapies will be used for her discomfort before medication. 3. Later, late decelerations of the fetal heart rate are noticed during contractions after Ms. AB receives pain medication. Actions will be taken to monitor

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    Case scenario

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    1. The nurse is asked to take Ms. AB, who is having contractions, to an intake room to determine the next steps in her care. The nurse will ask Ms. AB three initial questions and calculate her approximate date of gestation and estimated due date based on her last period. 2. Upon examination, Ms. AB is 80% effaced and 6 cm dilated with a regular fetal heart rate of 152 beats per minute. She will be admitted to the labor room and monitored, and alternative therapies will be used for her discomfort before medication. 3. Later, late decelerations of the fetal heart rate are noticed during contractions after Ms. AB receives pain medication. Actions will be taken to monitor

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    96 views2 pages

    OB Case Study 1

    Uploaded by

    Sdv
    1. The nurse is asked to take Ms. AB, who is having contractions, to an intake room to determine the next steps in her care. The nurse will ask Ms. AB three initial questions and calculate her approximate date of gestation and estimated due date based on her last period. 2. Upon examination, Ms. AB is 80% effaced and 6 cm dilated with a regular fetal heart rate of 152 beats per minute. She will be admitted to the labor room and monitored, and alternative therapies will be used for her discomfort before medication. 3. Later, late decelerations of the fetal heart rate are noticed during contractions after Ms. AB receives pain medication. Actions will be taken to monitor

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 2

    Case Study 1.

    Name: ____________________________________ Level: ________ Group: _____Date: _________

    INSTRUCTIONS. All questions apply to this case study. Your responses should be brief and direct to the point. When
    asked to provide several answers, list them in order of priority or significance. Do not assume information that is not
    provided. Please write your answers clearly/legibly. Corresponding credit (score)will not be given for answers that are
    not readable. Scan/take a picture of your answers and submit/upload the file thru VLE/MESSENGER/EMAIL.

    Test 1 Case Scenario

     Scenario: You are the nurse working in labor and delivery unit at a local hospital. Ms. AB comes to the unit
    having contractions and appears somewhat uncomfortable.You take her to the intake room to provide privacy,
    have her change into a gown, and ask her three initial questions to determine your next course of action, that is,
    whether to do a vaginal exam or to continue asking her more questions.
    1. What three initial questions will you ask, and why?
    1._______________________________________________________________
    2._______________________________________________________________
    3._______________________________________________________________
    2. She states that her last monthly period was last June 10, 2019. Compute for the AOG and EDC.
    1. AOG ______________
    2. EDC ______________
    3. Ms. AB has contractions 2 to 3 minutes apart lasting 45 seconds. It is her third pregnancy (gravida 3, para 2002). Her
    bag of water is intact at this time. Upon checking her UTZ report, her due date is 2 days away. You determine that it
    is appropriate to ask for further information before a vaginal exam is done. What information do you need?
    ______________________________________________________________________________________________
    ______________________________________________________________________________________________
    ______________________________________________________________________________________________
    4. Upon examination, Ms. AB is 80% effaced and 6 cm dilated. The fetal heart rate (FHR) is 152 beats/min and regular.
    She is admitted to the labor and delivery room in the unit. What nursing measures should be done at this time?
    ______________________________________________________________________________________________
    ______________________________________________________________________________________________
    ______________________________________________________________________________________________
    ______________________________________________________________________________________________
    ______________________________________________________________________________________________
    ______________________________________________________________________________________________
    5. List the stages of labor. Ms. AB is in what stage of labor?
    ______________________________________________________________________________________________
    ______________________________________________________________________________________________
    ______________________________________________________________________________________________
    ______________________________________________________________________________________________
    6. Ms. AB states that she is experiencing discomfort and asks you whether there is an alternative therapy available
    before taking medication. List at least two alternative methods in order to alleviate her discomfort.
    ______________________________________________________________________________________________
    ______________________________________________________________________________________________
    7. As you assess both the mother and the fetus during the active stage of labor, you will watch out for abnormal
    findings. Which of these are potential abnormal findings during labor?
    (Select all that apply.)
    a. Unusual bleeding
    b. Brown or greenish amniotic fluid
    c. Contractions that last 40 to 70 seconds
    d. Sudden, severe pain
    e. Increased maternal fatigue
    _____________________________

    1
     Case Study Progress
    Although Ms. AB continues to use alternative therapies for discomfort, she asks for pain medication and receives
    a dose of Hyoscine-N-Butylbromide (Buscopan) 10 mg IM and IV. Three hours later, MS. AB. is lying on her back,
    and during contractions you notice a few late decelerations of the FHR. You stayed with Ms. AB to monitor her
    and her fetus and immediately call for someone to notify the attending Physician.

    8. Put these actions in order of priority:


    a. Discontinue the oxytocin infusion.
    b. Turn Ms. AB onto her left side and elevate her legs.
    c. Increase the rate of the maintenance IV fluids.
    d. Administer oxygen at 8-10 L/min by facemask.
    ___ ___ ___ ____
    9. What are the 3 patterns of deceleration?
    __________________________________________________________________________________________________
    __________________________________________________________________________________________________
    __________________________________________________________________________________________________
    10. As you monitor Ms. AB, you observe for prolapse of the umbilical cord. Describe what this is and what can happen to
    the fetus if this occurs.
    __________________________________________________________________________________________________
    __________________________________________________________________________________________________
    __________________________________________________________________________________________________
    11. What would be the appropriate nursing actions if you noted that Ms. AB had a prolapsed cord?
    __________________________________________________________________________________________________
    __________________________________________________________________________________________________
    ___________________________________________________________

     Case Study progress


    The decelerations stopped, and the remainder of the labor is uneventful; Ms. AB had an episiotomy to facilitate
    the delivery of a male infant.
    12. What are the essential interventions in the immediate care of the newborn?
    __________________________________________________________________________________________________
    __________________________________________________________________________________________________

    13. Ms. AB. has her episiotomy repaired and the placenta delivered. What are the signs of placental expulsion?
    __________________________________________________________________________________________________
    __________________________________________________________________________________________________
    ___________________________________________________________
    14. What assessments are important for Ms. AB following delivery?
    __________________________________________________________________________________________________
    __________________________________________________________________________________________________
    ___________________________________________________________
    15. What interventions must be done in order to achieve and maintain a well contracted uterus to prevent hemorrhage?
    1. __________________________________________________________________________________
    2. ___________________________________________________________________________________
    3. ___________________________________________________________________________________
     Case Study Outcome:
    Ms. AB and her newborn baby girl are taken to the maternity unit where she begins to breastfeed him.
    15. What are the proper breastfeeding instructions that must be given to Ms. AB.
    __________________________________________________________________________________________________
    __________________________________________________________________________________________________
    __________________________________________________________________________________________________
    __________________________________________________________________________________________________
    __________________________________________________________________________________________________
    _________________________________________________________________________________________________
    Prepared by: Sharon M. De Vera RN, MAN
    Faculty NEU-CON

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