Unfolding Labor and Birth Case Study Notes Q&A 100% Correct Solution

Unfolding Labor and Birth Case Study Notes Q&A 100% Correct Solution -How many weeks gestation are you? (tells if it's preterm complications) -EDD? -Most recent doctor visit? -Last vaginal exam? -Consistency/occurence of contractions? -Has she tried anything to help contractions to relieve the pain? Does the pain go away? (this deciphers if they are braxton hicks - shows complications of true or false labor) -has her water broke? Symptoms: Pt. is in false labor if contractions are inconsistent - Answer-You are working as the triage nurse tonight. Your next patient to evaluate is patient Noel. When asked, "what brings you in tonight?" the patient states, "I have been feeling contractions off and on all evening, and now I can't sleep" -What other information do you need from the patient -How would you explain these symptoms -How close are her contractions -Have any bleeding? -Swab for a vag culture of Group B strep - if mom has this, give her antibiotics so baby won't be affected -what are her plans for pain amangement -she is in ACTIVE phase (cervical changes occur) -Fetus: descent has taken place - Answer-After returning from a 2 hour walk, patient Noel states her contractions are STRONGER and closer together. Upon exam, she has cervical change from 3cm 50% effacement and -3 station to 5-6cm, 75% effaced, -2 station. She is admitted to L&D with standard orders. -What other information would you need from the patient? -What stage of labor is she in? -In relation to labor mechanisms, what movement has taken place? -Obtain vitals -Assess FHR - continuous surveillence on baby (if baby is reactive with a normal FHR, we can do an intermittent so mom can walk around) - as long as baby has a reassuring strip -Do a whole admission process - what meds is she on? allergies? ask if she has a birth plan? -respect her culture -develop nurse-pt relationship -plans after delviery: breastfeed or bottle fed? Continues...