Question 2728

Question Answered step-by-step A 42-year-old woman named Alice enters the triage unit. She has… A 42-year-old woman named Alice enters the triage unit. She has been having contractions since this morning at 4:30 am. The contractions started at about 7 minutes apart. Her water broke on her way to the car at 10:00 am. It is now 12:00 pm. You ask Alice some admission questions.She states that she is 40 weeks pregnant, this is her second pregnancy. She had an abortion when she was 18 otherwise she has no other children. While completing the admission interview, you learn she is single and became pregnant through in vitro fertilization because she did not want to wait any longer to have a child as her clock was starting to count down. Her chart states that she was suspected of having gestational diabetes due to her fundus measuring large, however she tested negative and has had no other complications. Alice states that she wants to have a natural birth without an epidural. She did, however, learn about nitrous oxide and thought she may try that. What is her GTPAL:What information would you want to give her about her options for pain management during labor?1.2.3. Based on this admission information what are your top priority assessments?1.2.3. What priority labs need to be done before delivery?1. 2. 3.She is currently 4 cm dilated and 50 % effaced. Her vital signs are Temp-97.8 , HR-80, RR-22, BP-124/80, O2 sat- 97%. She is put on an external Fetal Heart Rate Monitor. The above strip shows the reading for the baby’s HR and variability along with mom’s contractions.How far apart are the contractions?  __________________________ About how long are they lasting? ______________________What stage of labor is Alice in? ________________What is the average Heart rate for the fetus? ____________What type of reading does this strip show? _______________________________________________________________________You complete the Leopold’s maneuver and find feet kicking under the left breast. A smooth surface under the right breast with a soft point on the top, and a firm bulge at the base of her pelvis with the firm part of the head on the left and the soft parts of the face up near the arms. What position is the baby in? _____________________________________________________________What are your priority interventions?1.2.3.At 2:00 pm you set Alice up with prn nitrous oxide for her to administer during her contractions.  It is now 6:00 pm. It has been 6 hours since Alice was admitted, and she has only dilated to 6 cm and is only 70% effaced. Her contractions are coming every 3 minutes and lasting for about 30-90 seconds on average. Alice is extremely distressed and in a lot of pain. She tells you that the contractions really hurt, and she is not sure she can do it anymore. The contractions are so painful, and she is unsure she can make it through the delivery without something more than the nitrous oxide. She had not considered what her other pain alternatives were and wants to know what her pain management options are at this stage of labor. What would be your response to Alice about her pain management options at this point in her labor?  Make sure to include their potential side effects.1.2.3.After your education, Alice chooses to have an epidural placed. The anesthesiologist comes.What position are you going to help Alice get in to have this epidural placed? Alice was able to get an epidural. What are your priority assessments after Alice has the epidural placed?1.2.3.During your post epidural placement assessment these are the vital signs you obtained: 97.8 ,  90, 22, 100/65, 97%. The FHM read that the fetus’s heart rate dropped to 90-100 bpm but with good variation. Based on these vital signs, what are your priority interventions for Alice and the fetus?1.2.3.Two hours (9:00 pm) after the epidural was placed Alice is 10cm dilated, 100% effaced, and feels the need to bare down. What stage of labor is Alice in? ____________________________________ What breathing technique would you encourage Alice to use during her contractions?_____________________________________________________What do you need to do now that Alice is ready to push?1.2.3.What are your priority interventions?1.2.3.After 50 minutes of pushing, Alice gives birth to a baby girl at 10:12pm. What stage of labor has Alice entered now? Health Science Science Nursing NU MISC Share QuestionEmailCopy link Comments (0)

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