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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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Hesi Prep maternity

Concepts Covered:

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

Study Plan Lessons

Alpha-fetoprotein (AFP) Lab Values

Antepartum Testing

Stages of Fetal Development Nursing Mnemonic (Proficiently Expanding Fetus)

What the Heck is Antepartum Testing? – Live Tutoring Archive

Antepartum Testing Case Study (45 min)

Blood Glucose Monitoring

Body System Assessments

Clindamycin (Cleocin) Nursing Considerations

Congestive Heart Failure (CHF) Labs

Disseminated Intravascular Coagulation (DIC)

Eye Prophylaxis for Newborn (Erythromycin)

Eye Prophylaxis for Newborn

Erythroblastosis Fetalis

Fetal Development

Fetal Distress Interventions Nursing Mnemonic (Stop MOAN)

Fetal Environment

Fetal Heart Monitoring (FHM)

Fetal Heart Monitoring Like A Pro – Live Tutoring Archive

Fetal Heart Monitoring Like A Pro 2 – Live Tutoring Archive

Gestational Diabetes (GDM)

Gestational Diabetes and Why YOU Should Know About It – Live Tutoring Archive

Gestational HTN (Hypertension)

Glucagon Lab Values

Glucose Tolerance Test (GTT) Lab Values

Gravidity and Parity (G&Ps, GTPAL)

HELLP Syndrome – Signs and Symptoms Nursing Mnemonic (HELLP)

Hemoglobin A1c (HbA1C)

Isotonic Solutions (IV solutions)

Labor Progression Case Study (45 min)

Leopold Maneuvers

Magnesium Sulfate

Magnesium Sulfate (MgSO4) Nursing Considerations

Magnesium Sulfate in Pregnancy

Maternal Risk Factors

Mechanisms of Labor

Meds for Postpartum Hemorrhage (PPH)

Meds for PPH (postpartum hemorrhage)

Methylergonovine (Methergine) Nursing Considerations

Newborn Physical Exam

Newborn Reflexes

Nifedipine (Procardia) Nursing Considerations

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

Nursing Care Plan (NCP) for Chorioamnionitis

Nursing Care Plan (NCP) for Diabetes Mellitus (DM)

Nursing Care Plan (NCP) for Dystocia

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

Nursing Care Plan (NCP) for Meconium Aspiration

Nursing Care Plan (NCP) for Newborns

Nursing Care Plan (NCP) for Placenta Previa

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

Nursing Care Plan (NCP) for Process of Labor

Nursing Care Plan (NCP) for Transient Tachypnea of Newborn

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

Nursing Care Plan for Newborn Reflexes

Nursing Case Study for Maternal Newborn

Nutrition Assessments

Nutrition in Pregnancy

Nutritional Requirements

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

OB Non-Stress Test Results Nursing Mnemonic (NNN)

OB Pharm and What Drugs You HAVE to Know – Live Tutoring Archive

Obstetrical Procedures

Opioid Analgesics in Pregnancy

Pediatric Vital Signs (VS)

Physiological Changes

Possible Infections During Pregnancy Nursing Mnemonic (TORCH)

Postpartum Discomforts

Postpartum Hematoma

Postpartum Hemorrhage (PPH)

Postpartum Interventions

Postpartum Physiological Maternal Changes

Postpartum Thrombophlebitis

Precipitous Labor

Preeclampsia (45 min)

Preeclampsia, Eclampsia, and HELLP Syndrome for Certified Emergency Nursing (CEN)

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

Preload and Afterload

Premature Rupture of the Membranes (PROM)

Probable Signs of Pregnancy Nursing Mnemonic (CHOP BUGS)

Process of Labor – Baby Nursing Mnemonic (ALPPPS)

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

Process of Labor 2 – Live Tutoring Archive

Prolapsed Umbilical Cord

Promethazine (Phenergan) Nursing Considerations

Prostaglandins in Pregnancy

Protein (PROT) Lab Values

Retinopathy of Prematurity (ROP)

Signs of Pregnancy (Presumptive, Probable, Positive)

Stages of Fetal Development Nursing Mnemonic (Proficiently Expanding Fetus)

Terbutaline (Brethine) Nursing Considerations

Umbilical Cord Vasculature Nursing Mnemonic (2A1V)

Uterine Stimulants (Oxytocin, Pitocin)

Uterine Stimulants (Oxytocin, Pitocin) Nursing Considerations

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