A nurse determines that a vaginal delivery of a vertex presentation is more likely to occur if the passenger (fetus) adapts to the passageway (pelvis) in which sequence of movements?
You note meconium in a 42 week gestation fetus when membrane…
You note meconium in a 42 week gestation fetus when membranes rupture at 6 cm dilation. The nurse is aware that:
A patient diagnosed with placenta previa would have which of…
A patient diagnosed with placenta previa would have which of the following assessment findings (select all that apply):
Case Study:Patient Profile:Name: Cece ParekhAge: 29 years ol…
Case Study:Patient Profile:Name: Cece ParekhAge: 29 years oldGravida: 2, Para: 1Estimated Gestational Age: 39 weeks + 2 daysAdmission: Labor and DeliveryCece Parekh is a 29-year-old G2P1 patient who is admitted to the labor and delivery unit at 39 weeks and 2 days for spontaneous onset of labor. She had an uncomplicated pregnancy with consistent prenatal care. Upon admission, she is 4 cm dilated, 80% effaced, and the fetal head is at -1 station. Her membranes are intact, and she is experiencing contractions every 5 minutes, lasting 45 seconds.Vital Signs on Admission:Temperature: 98.6°F (37°C)Pulse: 82 bpmRespirations: 18 breaths per minuteBlood Pressure: 128/80 mmHgFetal Heart Rate (FHR): 145 bpm, baseline with moderate variabilityHer last delivery was vaginal without complications. Cece expresses anxiety about labor pain but desires a natural birth without an epidural if possible.Assessment:The nurse performs Leopold’s maneuvers and determines that the baby is in a cephalic presentation. The fetal heart rate is monitored continuously, showing a baseline of 145 bpm with moderate variability and occasional early decelerations.What is the priority nursing action for Cece upon admission to the labor and delivery unit?a. Administer an IV analgesicb. Assess the fetal heart rate and contraction patternc. Encourage Cece to start pushingCece expresses concern about managing pain without an epidural. What non-pharmacological pain relief interventions could the nurse offer her?d. Encourage early administration of opioidse. Offer frequent position changes and breathing exercisesf. Suggest epidural anesthesia early in laborCece’s membranes rupture spontaneously, and the nurse notes green-tinged fluid. FHR remains within normal limits. What is the next priority nursing action?g. Turn the patient to the left lateral positionh. Document the color and amount of amniotic fluidi. Prepare for emergency deliveryAs labor progresses, Cece reports an uncontrollable urge to push. Upon assessment, she is 10 cm dilated and the fetal head is at +2 station. While Cece is pushing, the fetal heart rate drops to 100 bpm and remains there for two consecutive contractions while variability remains moderate. What is the nurse’s priority action?j. Call for immediate cesarean sectionk. Reposition the patientl. Continue to monitor the FHR closely
Your 39-week gestation patient, who was shopping at the mall…
Your 39-week gestation patient, who was shopping at the mall, presents to the labor room with low abdominal discomfort, irregular contractions, increased clear vaginal mucus, and a fetal heart rate (FHR) 136 and regular. The nursing plan of care should include:
The patient with gestational diabetes (GDM) presents for ind…
The patient with gestational diabetes (GDM) presents for induction of labor at 38- weeks gestation. The patient appears upset and tells the nurse that the physician informed her that her nonstress test (NST) is non-reactive and her amniotic fluid volume is reduced. The nurse’s best response would be:
A patient, who has a history of a previous cesarean section…
A patient, who has a history of a previous cesarean section with her first pregnancy, desires a trial of labor (TOLAC) to attempt vaginal delivery with her current pregnancy. The nurse knows to watch for signs of the biggest risk factor during a TOLAC:
The nurse is admitting a G3, P2 patient who is dilated to 8…
The nurse is admitting a G3, P2 patient who is dilated to 8 cm. What method of pain management should be avoided?
A patient is admitted for augmentation of labor. Oxytocin (…
A patient is admitted for augmentation of labor. Oxytocin (Pitocin) will be administered per policy titrating the dose of oxytocin (Pitocin) every 15 minutes. The titration will begin with the administration of 2 milliunits (mU) per minute per pump. For each nursing action listed below, choose if it is indicated or contraindicated.
A nurse is assessing a patient who is experiencing a prolong…
A nurse is assessing a patient who is experiencing a prolonged labor. The following assessment findings indicate that the patient is failing to progress in labor?