Question

Part 1: An 18 year old Primigravida presents to Labor And Delivery with what appears to be active labor. Upon questioning, you discover she has received no prenatal care. In obtaining some history while placing her on the fetal monitor you learn she is a smoker, approximately 1 pack per day, occasional marijuana for stress, and denies any support system. The Father of the Baby (FOB) has no knowledge of the pregnancy. No prenatal vitamins - they were too hard to swallow. She has no idea when her LMP was and she relates always being very irregular. * remember LMP is to ask the first day of the Last Menstrual cycle, not when the bleeding stopped*

What other questions are essential for her safe care? What lab values do you need to obtain? What exam findings should you obtain at this time? What education will you provide for her? She asks you how long this will take to have the baby - what is your best response?

Part 2: The patient is now 3cm/100% effaced /-2 station. What is the plan of care for the safety of this patient and her baby? Fetal heart rate is 160 with moderate variability. Contractions are now mild and 15 minutes in frequency.

1. Magnesium Sulfate is used to stop the contractions, and this has been successful. 2. What is the dose you will start with, what is the maintenance dose> 3. Please indicate what nursing interventions are necessary for use with Magnesium Sulfate?

Answer 1

# The other questions to be asked for her safe care are :-

- does she have any sexually transmitted disease

- does she take any over the counter drugs

- does she had completed her immunizations

- does she had any history abortion

- does she had any person with her for her care

- did she had any episodes of vaginal bleed

#. The lab valuy needs for the assessment are :-

- CBC

- LFT

- RFT

- Total iron

- folic acid level

- alpha fetoprotein

- creatinine

- lecithin : spyngomylein ratio for lung maturity of baby

- blood glucose

#. The examination findings should be done at this time are :-

Basic vitals

Cervical dilatation

Rupture of membrane

Position of the fetus

Leopold manuever

Descent of fetus

Heart rate( mother and fetus )

Aminiotic fluid assessment

#. The best response when the girl asks about the child birth ,the nurse should explain her that it takes a total duration of 280days equal to 9months or 37 weeks for child birth and she is in the active phase of labour means cervical dilatation is between 4-7cm and it would take 8-12 hours for the delivery of baby as she is a primigravida