Fetal Distress/Cesarean Section
RAPID Reasoning
Luella Jones, 25 years old
Primary Concept
Perfusion
Interrelated Concepts (In order of emphasis)
∙ Reproduction
∙ Clinical Judgment
NCLEX Client Need Categories Percentage of Items from Covered in
Each Category/Subcategory Case Study
Safe and Effective Care Environment
∙ Management of Care 17-23% ✔
∙ Safety and Infection Control 9-15%
Health Promotion and Maintenance 6-12% ✔
Psychosocial Integrity 6-12% ✔
Physiological Integrity
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, ∙ Basic Care and Comfort 6-12% ✔
∙ Pharmacological and Parenteral Therapies 12-18% ✔
∙ Reduction of Risk Potential 9-15% ✔
∙ Physiological Adaptation 11-17% ✔
© 2018 Keith Rischer/www.KeithRN.com
RAPID Reasoning Case Study
History of Present Problem:
Luella Jones is a 25-year-old female patient G1P0 who is currently 40 3/7 weeks gestation. She is admitted to the
hospital to be induced for being post-date. She is positive for Group Beta streptococcus and receiving IV antibiotics per
protocol. She is 65 inches (162.5 cm). Her pre-pregnancy weight was 115 pounds (52.3 kg). She gained 15 pounds (6.8
kg) during this pregnancy. She just had spontaneous rupture of membranes with a moderate amount of thick meconium
fluid. The nurse performed a vaginal check, and her cervix is dilated to 4 cm, 8 percent effaced and -1 station. Pitocin is
infusing at 6 mU/minute intravenously.
Personal/Social History:
Luella lives alone and is no longer involved with the father of her baby. Her family support is limited to her older sister.
She smokes one pack of cigarettes a day and has not had a job for over a year and states money is tight. She admits to not
eating very healthy during the pregnancy because it is easier to grab chips and pop than cook. She missed a few of her
prenatal visits due to transportation issues and did not attend any prenatal classes. Her sister is present as her support
person during labor and delivery.
What data from the histories are RELEVANT and must be interpreted as clinically significant by the nurse?
RELEVANT Data from Present Problem: Clinical Significance:
Luella Jones It's crucial to assess her size to determine if she might face
-65inches (5ft6in) difficulties during delivery if the baby is larger than expected for
115lbs and only gained 15 pounds her small pelvis. She has gained less weight than expected and is
-25 year old G1P0
concerned about the baby being born underweight (small for
-Group Beta Streptococcus positive
-SROM gestational age). This is her first pregnancy. The presence of thick
-4cm dilated meconium suggests the baby is experiencing significant stress in
-80% effaced utero. She is progressing, but not yet ready for a vaginal delivery.
-Thick meconium
RELEVANT Data from Social History: Clinical Significance:
Lives alone and father of baby not Smoking increases the risk of birth defects, such as low birth
involved weight and the possibility of secondhand smoke exposure, which
Smokes is linked to SIDS.
Missed some prenatal visits If the mother isn't getting enough nutrients, it can affect the baby's
Sister is present for support development, which may be indicated by minimal weight gain.
She has at least one person available to provide support during her
pregnancy.
This study source was downloaded by 100000897367967 from CourseHero.com on 09-11-2025 07:05:28 GMT -05:00
https://www.coursehero.com/file/247093805/Case-Study-Fetal-Distress-RAPID-Reasoning-2pdf/
RAPID Reasoning
Luella Jones, 25 years old
Primary Concept
Perfusion
Interrelated Concepts (In order of emphasis)
∙ Reproduction
∙ Clinical Judgment
NCLEX Client Need Categories Percentage of Items from Covered in
Each Category/Subcategory Case Study
Safe and Effective Care Environment
∙ Management of Care 17-23% ✔
∙ Safety and Infection Control 9-15%
Health Promotion and Maintenance 6-12% ✔
Psychosocial Integrity 6-12% ✔
Physiological Integrity
This study source was downloaded by 100000897367967 from CourseHero.com on 09-11-2025 07:05:28 GMT -05:00
https://www.coursehero.com/file/247093805/Case-Study-Fetal-Distress-RAPID-Reasoning-2pdf/
, ∙ Basic Care and Comfort 6-12% ✔
∙ Pharmacological and Parenteral Therapies 12-18% ✔
∙ Reduction of Risk Potential 9-15% ✔
∙ Physiological Adaptation 11-17% ✔
© 2018 Keith Rischer/www.KeithRN.com
RAPID Reasoning Case Study
History of Present Problem:
Luella Jones is a 25-year-old female patient G1P0 who is currently 40 3/7 weeks gestation. She is admitted to the
hospital to be induced for being post-date. She is positive for Group Beta streptococcus and receiving IV antibiotics per
protocol. She is 65 inches (162.5 cm). Her pre-pregnancy weight was 115 pounds (52.3 kg). She gained 15 pounds (6.8
kg) during this pregnancy. She just had spontaneous rupture of membranes with a moderate amount of thick meconium
fluid. The nurse performed a vaginal check, and her cervix is dilated to 4 cm, 8 percent effaced and -1 station. Pitocin is
infusing at 6 mU/minute intravenously.
Personal/Social History:
Luella lives alone and is no longer involved with the father of her baby. Her family support is limited to her older sister.
She smokes one pack of cigarettes a day and has not had a job for over a year and states money is tight. She admits to not
eating very healthy during the pregnancy because it is easier to grab chips and pop than cook. She missed a few of her
prenatal visits due to transportation issues and did not attend any prenatal classes. Her sister is present as her support
person during labor and delivery.
What data from the histories are RELEVANT and must be interpreted as clinically significant by the nurse?
RELEVANT Data from Present Problem: Clinical Significance:
Luella Jones It's crucial to assess her size to determine if she might face
-65inches (5ft6in) difficulties during delivery if the baby is larger than expected for
115lbs and only gained 15 pounds her small pelvis. She has gained less weight than expected and is
-25 year old G1P0
concerned about the baby being born underweight (small for
-Group Beta Streptococcus positive
-SROM gestational age). This is her first pregnancy. The presence of thick
-4cm dilated meconium suggests the baby is experiencing significant stress in
-80% effaced utero. She is progressing, but not yet ready for a vaginal delivery.
-Thick meconium
RELEVANT Data from Social History: Clinical Significance:
Lives alone and father of baby not Smoking increases the risk of birth defects, such as low birth
involved weight and the possibility of secondhand smoke exposure, which
Smokes is linked to SIDS.
Missed some prenatal visits If the mother isn't getting enough nutrients, it can affect the baby's
Sister is present for support development, which may be indicated by minimal weight gain.
She has at least one person available to provide support during her
pregnancy.
This study source was downloaded by 100000897367967 from CourseHero.com on 09-11-2025 07:05:28 GMT -05:00
https://www.coursehero.com/file/247093805/Case-Study-Fetal-Distress-RAPID-Reasoning-2pdf/
