Question

Clinical makeup Spring 2019 Review Chapter 25 in your textbook and complete the following case study: Renee is a 22-year-old G2 PO at 42 weeks of gestation in active spontaneous labor. Her pregnancy has been complicated by mild hypertension, but no medications were needed. She is 4 cm/100/0 station, vertex position. Her membranes have just ruptured, and there is thick meconium staining. She is comfortable and utilizing epidural anesthesia. 1. What risk factors are present that may impact the way this fetus tolerates labor? 2. The fetal heart rate shows a rate of 140, moderate variability, no accelerations, and decelerations to 120 beginning after the peak of most contractions and recovering to baseline 30 seconds after the contraction ends. Contractions are every 4 minutes. How should the nurse describe this pattern? 3. What should the nurse do at this point? 4 Renee is now 8/100/0. She is in the left lateral Obuchve position with oxygen at 8 liters/minute. The fetal heart s ich rate is 145. There is moderate variability. Accelerations are not present. There are 100 e decelerations in the fetal heart rate beginning at the 0 31 onset of a contraction, descending to 120 with recovery by the end of a contraction. The contractions i ara

Answer 1

1.as there is a thick msl present there r more chances of msl aspiration by the fetus which may causes sudden iud. And also pt is in 4 cms as the labour progresses there r increase in uterine contractions which can increase more msl and chances of aspiration.

2.in normal ctg there is no decleration early decleration that is jst after contraction is suggestive of fetal hypoxia.

3.immediately nursing staff have to rotate the pt left lateral start oxygen at rate of 6-8 litres/min, wash the msl by doing amnioinfusion per vaginally, also start soda bicarbonate in a drip.