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?

Please provide APA format References

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

Some of the questions to be raised for her safe care are

• Her medical history and any other OTC drand
• Her diet should be asked ,because it plays a key role inbthe development of the foetus
• Presence of any infections
• Lifestyle and family support can be asked for,because she is UN UN tender age to accept and prolong pregnancy
• Her gestational history can be asked for planning care
• Is she having any fetal movement, physiological changes ,this helps to predict the trimester

The following laboratory examination is a must

• CBC:to assess patiwnt for anaemia, infection and is a basic test
• Triple H:HIV HCV, Hepatitis B to rule out any infection and prevent the complications during the delivery
• Gonorrhoea and syphilis to be tested and appropriate action to be taken
• Ultrasound to determine the position ,lie, fetal weight,height,growth has to be assessed

The examination finding at this stage are

• The fetal lie and position
• Fetal heart rate
• Assess for any signs of fetal distress
• Assess the mother's vital signs

The following education is needed at this time

• Educating her about the preparation for delivery
• Simple enema to relieve any fetal impaction
• support her physically and psychologically
• Educatingher about the stages of Labour

She has to be informed that the first delivery takes approximately 18 hours to deliver a baby in case of primigravida.