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Labor Progression Case Study (45 min)

Labor Progression Case Study (45 min)

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Outline

A 27-year-old female who is 40 weeks and 2 days pregnant, with contractions occurring once every 10 minutes. The patient is checked in, vital signs are normal, fetal heart tones are normal and the mother and father to-be are settled into their room for the night. It is 4 am and the call light goes off. The patient reports she is feeling contractions every 2 minutes now and she thinks her water may have broken.

Critical Thinking Check

Bloom's Taxonomy: Application

How can the nurse find out if the patients water has broken?

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Critical Thinking Check

Bloom's Taxonomy: Comprehension

What color should the test be if the membranes have ruptured?

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The nurse prepares to test the fluid that has leaked down the patients’ leg. The test comes back positive for amniotic fluid. The nurse informs the doctor and prepares the patient to deliver.

Critical Thinking Check

Bloom's Taxonomy: Application

What is the most important thing to have ready at this time?

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The nurse is prepared for the delivery and is talking the mother through her breathing, the cervix is dilated to 7 cm and the contractions are now 1 minute apart.

Vital signs are as follows:

RR 30 bpm

HR 125 bpm

BP 110/67 mmHg

Fetal HR 133 bpm

The nurse checks the presentation of the baby and notes the baby head is in the vertex position, the bottom is in the frank position and baby is in the -1 station.

Critical Thinking Check

Bloom's Taxonomy: Comprehension

What station number means the baby is starting to come out?

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Critical Thinking Check

Bloom's Taxonomy: Comprehension

What cardinal movement is the baby currently in?

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The nurse monitors mom and baby for another hour and upon re-checking the position of the baby the nurse notes that the baby is now +1 station and the cardinal movement is descent and flexion.

Critical Thinking Check

Bloom's Taxonomy: Application

What does the nurse need to make sure has happened?

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As the baby is delivered the occiput is facing the right side of the pelvis and towards the front.

Critical Thinking Check

Bloom's Taxonomy: Comprehension

What position is the newborn in at delivery?

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OB

Concepts Covered:

Pregnancy Risks
Labor Complications
Newborn Complications
Fetal Development
Terminology
Prenatal Concepts
Newborn Care
Postpartum Care
Postpartum Complications
Medication Administration
Labor and Delivery
Studying
Communication

Study Plan Lessons

Abortion in Nursing: Spontaneous, Induced, and Missed

Abruptio Placentae (Placental abruption)

Acyclovir (Zovirax) Nursing Considerations

Addicted Newborn

Alpha-fetoprotein (AFP) Lab Values

Anemia in Pregnancy

Antepartum Testing

Antepartum Testing Case Study (45 min)

Betamethasone and Dexamethasone

Betamethasone and Dexamethasone in Pregnancy

Butorphanol (Stadol) Nursing Considerations

Cardiac (Heart) Disease in Pregnancy

Causes of Chorioamnionitis Nursing Mnemonic (Pregnancies Are Very Interesting)

Causes of Labor Dystocia Nursing Mnemonic (Having Extremely Frustrating Labor)

Causes of Postpartum Hemorrhage Nursing Mnemonic (4 T’s)

Chorioamnionitis

Day in the Life of a Labor Nurse

Day in the Life of a Postpartum Nurse

Discomforts of Pregnancy

Disseminated Intravascular Coagulation (DIC)

Ectopic Pregnancy

Ectopic Pregnancy Case Study (30 min)

Emergent Delivery (OB) (30 min)

Episiotomy – Evaluation of Healing Nursing Mnemonic (REEDA)

Erythroblastosis Fetalis

Eye Prophylaxis for Newborn

Factors That Can Put a Pregnancy at Risk Nursing Mnemonic (RIBCAGE)

Family Planning & Contraception

Fertilization and Implantation

Fetal Alcohol Syndrome (FAS)

Fetal Circulation

Fetal Development

Fetal Distress Interventions Nursing Mnemonic (Stop MOAN)

Fetal Heart Monitoring (FHM)

Fetal Environment

Fetal Wellbeing Assessment Tests Nursing Mnemonic (ALONE)

Fundal Height Assessment for Nurses

Gestation & Nägele’s Rule: Estimating Due Dates

Gestational Diabetes (GDM)

Gestational HTN (Hypertension)

Glucose Tolerance Test (GTT) Lab Values

Gravidity and Parity (G&Ps, GTPAL)

HELLP Syndrome – Signs and Symptoms Nursing Mnemonic (HELLP)

Hematomas in OB Nursing: Causes, Symptoms, and Nursing Care

Hemorrhage (Postpartum Bleeding) for Certified Emergency Nursing (CEN)

Hepatitis B Vaccine for Newborns

Homocysteine (HCY) Lab Values

Hydatidiform Mole (Molar pregnancy)

Hyperemesis Gravidarum

Hypovolemic Shock Case Study (OB sim) (60 min)

Incompetent Cervix

Infections in Pregnancy

Initial Care of the Newborn (APGAR)

Intra Uterine Device – Potential Problems Nursing Mnemonic (PAINS)

Labor Progression Case Study (45 min)

Leopold Maneuvers

Lung Surfactant for Newborns

Magnesium Sulfate (MgSO4) Nursing Considerations

Magnesium Sulfate in Pregnancy

Maternal Risk Factors

Mechanisms of Labor

Meconium Aspiration

Meds for Postpartum Hemorrhage (PPH)

Menstrual Cycle

Newborn of HIV+ Mother

Newborn Physical Exam

Newborn Reflexes

Nursing Care Plan (NCP) for Abortion, Spontaneous Abortion, Miscarriage

Nursing Care Plan (NCP) for Abruptio Placentae / Placental abruption

Nursing Care Plan (NCP) for Chorioamnionitis

Nursing Care Plan (NCP) for Dystocia

Nursing Care Plan (NCP) for Ectopic Pregnancy

Nursing Care Plan (NCP) for Gestational Diabetes (GDM)

Nursing Care Plan (NCP) for Gestational Hypertension, Preeclampsia, Eclampsia

Nursing Care Plan (NCP) for Hyperemesis Gravidarum

Nursing Care Plan (NCP) for Incompetent Cervix

Nursing Care Plan (NCP) for Mastitis

Nursing Care Plan (NCP) for Maternal-Fetal Dyad Using GTPAL

Nursing Care Plan (NCP) for Meconium Aspiration

Nursing Care Plan (NCP) for Neonatal Jaundice | Hyperbilirubinemia

Nursing Care Plan (NCP) for Newborns

Nursing Care Plan (NCP) for Placenta Previa

Nursing Care Plan (NCP) for Postpartum Hemorrhage (PPH)

Nursing Care Plan (NCP) for Premature Rupture of Membranes (PROM) / Preterm Premature Rupture of Membranes (PPROM)

Nursing Care Plan (NCP) for Preterm Labor / Premature Labor

Nursing Care Plan (NCP) for Process of Labor

Nursing Care Plan for (NCP) Fetal Alcohol Syndrome (FAS)

Nursing Care Plan (NCP) for Transient Tachypnea of Newborn

Nursing Case Study for Maternal Newborn

Nutrition in Pregnancy

OB (Labor) Nurse Report to OB (Postpartum) Nurses

OB Non-Stress Test Results Nursing Mnemonic (NNN)

Obstetric Trauma for Certified Emergency Nursing (CEN)

Obstetrical Procedures

Opioid Analgesics in Pregnancy

Oral Birth Control Pills – Serious Complications Nursing Mnemonic (Aches)

Oxytocin (Pitocin) Nursing Considerations

Pediatric Vital Signs (VS)

Phytonadione (Vitamin K) for Newborn

Placenta Previa for Certified Emergency Nursing (CEN)

Possible Infections During Pregnancy Nursing Mnemonic (TORCH)

Post-Partum Assessment Nursing Mnemonic (BUBBLE)

Postpartum Discomforts

Postpartum Hematoma

Postpartum Interventions

Postpartum Physiological Maternal Changes

Preeclampsia (45 min)

Postpartum Thrombophlebitis

Precipitous Labor

Preeclampsia: Signs, Symptoms, Nursing Care, and Magnesium Sulfate

Pregnancy Outcomes Nursing Mnemonic (GTPAL)

Preterm Labor for Certified Emergency Nursing (CEN)

Process of Labor – Mom Nursing Mnemonic (4 P’s)

Process of Labor – Baby Nursing Mnemonic (ALPPPS)

Prolapsed Umbilical Cord

Prostaglandins in Pregnancy

Rh Immune Globulin in Pregnancy

Signs of Pregnancy (Presumptive, Probable, Positive)

Stages of Fetal Development Nursing Mnemonic (Proficiently Expanding Fetus)

Tips & Advice for Newborns (Neonatal IV Insertion)

Threatened/Spontaneous Abortion for Certified Emergency Nursing (CEN)

Uterine Stimulants (Oxytocin, Pitocin) Nursing Considerations

VEAL CHOP Nursing Mnemonic (Fetal Accelerations and Decelerations) (VEAL CHOP)