Denver College of Nursing: OB Preparation Packet
Self-Study Guide
Fall 2022
Student Name: Tria Simmons
Cohort letter and #: B3 Please Read All
Directions First!
This OB Preparation Packet (“OB Prep Packet”) will help prepare you to SUCCEED at your upcoming OB
clinical and simulation experiences. All questions must be answered.
1. View the OB Orientation informational video on mydsn.net (faculty resources/program resources/
NUR 350/NUR 250) prior to filling out the OB Prep Packet and your OB Orientation. Answers to
questions can be found in the video!
2. To answer ALL the questions: use the OB Orientation video, your OB textbook and/or online
version, Maternity & Women’s Health Care by Lowdermilk, et al. (2020), AND the OB
Medication Log.
3. Must be typed. Recommend using a color other than black for your answers.
4. You will need to use your Common OB Abbreviations (also attached to this email) to help you
interpret and understand the information in the case studies and questions.
5. The OB Prep Packet will not be graded; however, it will be reviewed for completion in order to
receive credit. Upload the completed assignment to the Simulation Canvas assignment drop box.
Due: on or before Saturday, October 15, 2022 by 11:59 pm.
6. If you have OB clinical starting WEEK 1 of Quarter 5 (Fall 2022), complete your OB
Prep Packet BEFORE attending clinical to better prepare you for the experience.
During the OB Orientation, your instructors will spend additional time reviewing the case studies to help you
further complete this OB Prep Packet. We encourage you to include in-text citations with each answer for your
future reference.
BRING this OB Preparation Packet to ALL OB clinicals & simulations
(You are expected to know this information for both)
OB Preparation: Labor and Delivery
Use your OB textbook, Maternity & Women’s Health Care by Lowdermilk, et al., (2020, 12th edition, chapters
18, 19) or online version (Part 4) and the OB Orientation video viewed from mydsn.net to answer the questions
below based on the following scenario.
, Case Study
Camila Moreno just arrived in Labor and Delivery (L & D) triage at 14:30. She is a 27 y/o Latina female,
gravida 2, para 1 (G2 P1 or G2 P1001) currently at 39 weeks’ gestation. The baby is due next week. Her first
baby (girl, now 2) was delivered via vaginal delivery after an induced labor of 16 hrs., no complications. She
has received routine prenatal care with this pregnancy, is GBS negative, blood type A positive, and is rubella
immune. She plans to breastfeed. Camila stated that she has “been having contractions every 5-8 minutes at
home for the last 2 hours and they are getting stronger.” She also stated that she had been having "a lot of
false labor" in the last few days and feels anxious that “this baby is taking so long to get here.” She hopes that
she is now truly in labor. She reports active fetal movement and has some pink tinged vaginal discharge. No
leakage of amniotic fluid (no rupture of membranes) noted. When asked to rate her pain, she replies that her
current pain level is 7 on a scale of 0 to 10. Camila states she would like an epidural for pain relief.
Camila’s VS: Temp 98.8°F (37.1° C) HR 80, RR 18, O2 Sat 95% on RA, and BP 120/76. After putting Camila
on the electronic fetal monitor for 20 minutes, the fetal heart rate (FHR) baseline is 140 bpm with moderate
variability, several accelerations are present, and no decelerations noted.”
Her contractions are now 3-5 min apart, lasting 60 seconds and palpate moderate intensity. The nurse
performs a sterile vaginal exam (SVE) and notes the patient’s cervix is 6 cm dilated, 90% effaced, with baby's
head at +1 station (6/90/+1), cervix is soft and anterior. The amniotic membranes are intact. Bilateral lower
extremity exam: DTR’s are 2+, no clonus, with 1+ edema, no DVT noted. She gave a urine specimen 30 min
ago in triage, results are pending. States she had a BM this morning. She last ate at 0800, breakfast of yogurt,
banana, and juice. The nurse reports their findings to the Certified Nurse-Midwife (CNM) and receives an
order to admit the patient to L & D.
1. What is the normal range of the fetal heart rate (FHR) baseline? How many minutes on the EFM are
needed to determine the baseline?
The normal FHR range is 110 to 160 beats/min (Lowdermilk, et al., 2020).
2. Describe the FHR pattern from above, including baseline, variability and presence or absence of
accelerations and/or decelerations. Is Camila’s fetus well oxygenated? Why or why not? Be specific.
The fetus baseline is 130, this is normal. As gestation continues the fetal heart rate will decrease as the fetus
progresses to term. Variability: moderate variability. 6-25 beats per minute, predicting normal fetal acid base
balance. Several acceleration present that can be due to fetal movement, vaginal examination, contractions, or
several other things. No decelerations present. The fetus is well oxygenated indicated by the accelerations
3. What would be Camila’s specific “BUBBLE LE” assessment? (The BUBBLE LE is a DCN acronym
for the antepartum, intrapartum, and postpartum patient’s “Focused Assessment.”) (See
the OB Orientation video and based on the information in the case study above).
B (Background/Plans to Breast and/or Bottle feed?) age, G P, # of weeks pregnant, PMHx, labs (GBS,
blood type, etc.), VS, other important information
She is a 27-year-old Latina female, gravida 2, para 1 (G2 P1 or G2 P1001) currently at 39 weeks’
gestation presenting with regular contractions. Her first pregnancy was vaginal delivery after being
induced and 16 hours of labor. GPS negative and positive immune rubella. She plans to breast feed.
Vitals are all within normal limits but is experiencing some pain
CAW/OB Team Fall 2022 Page 2
, U (Uterus- UCs frequency, duration, intensity, fetal heart rate “FHR”- baseline, variability,
accels/decels, fetal movement “FM”)
Contractions are 3-5 minutes apart, and last 60 seconds, upon palpation, moderate intensity. FHR
baseline is 140, moderate variability, several accel present and no decels noted
B (Bladder-last voided, TACCO)
She last voided 30 min ago in triage
B (Bowel- last BM/last food intake & time)
She States she had a BM this morning. She last ate at 0800, breakfast of yogurt, banana, and juice.
L (Leakage of fluid, TACCO)
Pink-tinged vaginal discharge, membranes intact
E (Effacement/Cervical exam/SVE-dilation/effacement/station)
Her cervix is 6 cm dilated, +1, 90% effaced, soft and anterior membranes are intact
L (Lower extremities-DTRs/clonus/edema/DVT)
DTRs 2+ in lower extremities, +1 edema noted bilaterally, no clonus or DVT noted
E (Emotions- how is she coping?)
She is anxious and excited
4. Accelerations are OK! What is the definition of the FHR acceleration?
An acceleration is an abrupt increase in FHR above the baseline that peaks less than 30 seconds and at least 15
bpm above baseline, and 15 seconds to 2 minutes in duration. Accelerations are associated with fetal
movement, stimulation, or environmental stimuli, and considered reassuring indicting an intact fetal central
nervous system.
5. Decelerations (“decels”), or a decrease in the FHR from baseline, can happen during the labor and
delivery of a newborn and can be seen on electronic fetal monitoring.
Describe the 3 different decelerations below answering all parts.
-Variable Deceleration- (possible shapes of this decel include “V, W, U”)
-Duration in seconds from onset to nadir of decel?
Deceleration of 15bmp below baseline. Can last 15 seconds and up to 2 min.
Abrupt or gradual drop in FHR?
Abrupt decrease in FHR with a rapid downslope and variable recovery phase.
relationship to a contraction’s beginning, peak, and end?
The duration and timing can vary and may or may not be in relation to the uterine contraction.
CAW/OB Team Fall 2022 Page 3
Self-Study Guide
Fall 2022
Student Name: Tria Simmons
Cohort letter and #: B3 Please Read All
Directions First!
This OB Preparation Packet (“OB Prep Packet”) will help prepare you to SUCCEED at your upcoming OB
clinical and simulation experiences. All questions must be answered.
1. View the OB Orientation informational video on mydsn.net (faculty resources/program resources/
NUR 350/NUR 250) prior to filling out the OB Prep Packet and your OB Orientation. Answers to
questions can be found in the video!
2. To answer ALL the questions: use the OB Orientation video, your OB textbook and/or online
version, Maternity & Women’s Health Care by Lowdermilk, et al. (2020), AND the OB
Medication Log.
3. Must be typed. Recommend using a color other than black for your answers.
4. You will need to use your Common OB Abbreviations (also attached to this email) to help you
interpret and understand the information in the case studies and questions.
5. The OB Prep Packet will not be graded; however, it will be reviewed for completion in order to
receive credit. Upload the completed assignment to the Simulation Canvas assignment drop box.
Due: on or before Saturday, October 15, 2022 by 11:59 pm.
6. If you have OB clinical starting WEEK 1 of Quarter 5 (Fall 2022), complete your OB
Prep Packet BEFORE attending clinical to better prepare you for the experience.
During the OB Orientation, your instructors will spend additional time reviewing the case studies to help you
further complete this OB Prep Packet. We encourage you to include in-text citations with each answer for your
future reference.
BRING this OB Preparation Packet to ALL OB clinicals & simulations
(You are expected to know this information for both)
OB Preparation: Labor and Delivery
Use your OB textbook, Maternity & Women’s Health Care by Lowdermilk, et al., (2020, 12th edition, chapters
18, 19) or online version (Part 4) and the OB Orientation video viewed from mydsn.net to answer the questions
below based on the following scenario.
, Case Study
Camila Moreno just arrived in Labor and Delivery (L & D) triage at 14:30. She is a 27 y/o Latina female,
gravida 2, para 1 (G2 P1 or G2 P1001) currently at 39 weeks’ gestation. The baby is due next week. Her first
baby (girl, now 2) was delivered via vaginal delivery after an induced labor of 16 hrs., no complications. She
has received routine prenatal care with this pregnancy, is GBS negative, blood type A positive, and is rubella
immune. She plans to breastfeed. Camila stated that she has “been having contractions every 5-8 minutes at
home for the last 2 hours and they are getting stronger.” She also stated that she had been having "a lot of
false labor" in the last few days and feels anxious that “this baby is taking so long to get here.” She hopes that
she is now truly in labor. She reports active fetal movement and has some pink tinged vaginal discharge. No
leakage of amniotic fluid (no rupture of membranes) noted. When asked to rate her pain, she replies that her
current pain level is 7 on a scale of 0 to 10. Camila states she would like an epidural for pain relief.
Camila’s VS: Temp 98.8°F (37.1° C) HR 80, RR 18, O2 Sat 95% on RA, and BP 120/76. After putting Camila
on the electronic fetal monitor for 20 minutes, the fetal heart rate (FHR) baseline is 140 bpm with moderate
variability, several accelerations are present, and no decelerations noted.”
Her contractions are now 3-5 min apart, lasting 60 seconds and palpate moderate intensity. The nurse
performs a sterile vaginal exam (SVE) and notes the patient’s cervix is 6 cm dilated, 90% effaced, with baby's
head at +1 station (6/90/+1), cervix is soft and anterior. The amniotic membranes are intact. Bilateral lower
extremity exam: DTR’s are 2+, no clonus, with 1+ edema, no DVT noted. She gave a urine specimen 30 min
ago in triage, results are pending. States she had a BM this morning. She last ate at 0800, breakfast of yogurt,
banana, and juice. The nurse reports their findings to the Certified Nurse-Midwife (CNM) and receives an
order to admit the patient to L & D.
1. What is the normal range of the fetal heart rate (FHR) baseline? How many minutes on the EFM are
needed to determine the baseline?
The normal FHR range is 110 to 160 beats/min (Lowdermilk, et al., 2020).
2. Describe the FHR pattern from above, including baseline, variability and presence or absence of
accelerations and/or decelerations. Is Camila’s fetus well oxygenated? Why or why not? Be specific.
The fetus baseline is 130, this is normal. As gestation continues the fetal heart rate will decrease as the fetus
progresses to term. Variability: moderate variability. 6-25 beats per minute, predicting normal fetal acid base
balance. Several acceleration present that can be due to fetal movement, vaginal examination, contractions, or
several other things. No decelerations present. The fetus is well oxygenated indicated by the accelerations
3. What would be Camila’s specific “BUBBLE LE” assessment? (The BUBBLE LE is a DCN acronym
for the antepartum, intrapartum, and postpartum patient’s “Focused Assessment.”) (See
the OB Orientation video and based on the information in the case study above).
B (Background/Plans to Breast and/or Bottle feed?) age, G P, # of weeks pregnant, PMHx, labs (GBS,
blood type, etc.), VS, other important information
She is a 27-year-old Latina female, gravida 2, para 1 (G2 P1 or G2 P1001) currently at 39 weeks’
gestation presenting with regular contractions. Her first pregnancy was vaginal delivery after being
induced and 16 hours of labor. GPS negative and positive immune rubella. She plans to breast feed.
Vitals are all within normal limits but is experiencing some pain
CAW/OB Team Fall 2022 Page 2
, U (Uterus- UCs frequency, duration, intensity, fetal heart rate “FHR”- baseline, variability,
accels/decels, fetal movement “FM”)
Contractions are 3-5 minutes apart, and last 60 seconds, upon palpation, moderate intensity. FHR
baseline is 140, moderate variability, several accel present and no decels noted
B (Bladder-last voided, TACCO)
She last voided 30 min ago in triage
B (Bowel- last BM/last food intake & time)
She States she had a BM this morning. She last ate at 0800, breakfast of yogurt, banana, and juice.
L (Leakage of fluid, TACCO)
Pink-tinged vaginal discharge, membranes intact
E (Effacement/Cervical exam/SVE-dilation/effacement/station)
Her cervix is 6 cm dilated, +1, 90% effaced, soft and anterior membranes are intact
L (Lower extremities-DTRs/clonus/edema/DVT)
DTRs 2+ in lower extremities, +1 edema noted bilaterally, no clonus or DVT noted
E (Emotions- how is she coping?)
She is anxious and excited
4. Accelerations are OK! What is the definition of the FHR acceleration?
An acceleration is an abrupt increase in FHR above the baseline that peaks less than 30 seconds and at least 15
bpm above baseline, and 15 seconds to 2 minutes in duration. Accelerations are associated with fetal
movement, stimulation, or environmental stimuli, and considered reassuring indicting an intact fetal central
nervous system.
5. Decelerations (“decels”), or a decrease in the FHR from baseline, can happen during the labor and
delivery of a newborn and can be seen on electronic fetal monitoring.
Describe the 3 different decelerations below answering all parts.
-Variable Deceleration- (possible shapes of this decel include “V, W, U”)
-Duration in seconds from onset to nadir of decel?
Deceleration of 15bmp below baseline. Can last 15 seconds and up to 2 min.
Abrupt or gradual drop in FHR?
Abrupt decrease in FHR with a rapid downslope and variable recovery phase.
relationship to a contraction’s beginning, peak, and end?
The duration and timing can vary and may or may not be in relation to the uterine contraction.
CAW/OB Team Fall 2022 Page 3
