Case Study
A patient is full term and contractions are q20mins pain 2/10 what stage of labor is she and is she urgent?
Early and not Priority
Why should call DR ASAP
Elevated temp Elevated or low B/P maternal HR more than 110 RR more than 24 abnormal FHR imminent delivery
Uterine rupture
Constant pain
38 weeks gestation 1st baby water breaks 12hrs 3cm 50% effaced sharp decline not related to contractions =
Variable, amino infusion, for cord compression
Absence
0 no change
A patient comes in 8cm what stage is she
First stage/Transition
Expected blood loss w/ vaginal delivery
500
Cord prolapse
cord deliver 1st
elevate presenting part
c/s
Indications for c/s
Malpresentation
Previa
elective
PRe-E
labor dystopia
Minimal
1-5
Patient pain is 10/10 7cm dilated with low grade fever and HTN what stage and is she priority
1st/active & Priority
Lab Test
Type & Screen RH
CBC Urinalysis
Signs of fetal distress
bradycardia
late decel
prolonged decile beyond 2min
Major concern with epidural
hypotension
Moderate
well oxygenated 5-25
Pt comes in 5th pregnancy and had no prenatal care she now has vaginal bleeding you put her on the monitor she has late decals what is now concern and why
the late decal is urgent as and placenta problem
True Labor
Longer stronger closer contractions
Start at top
Cant be stopped
Cervix change
TOLAC
No Classic Incision
Precious c/s
How to fix variable
amnioinfusin or positioning
Interventions for induction
manual dilation
prostaglandin
pictocin
AROM
FHR monitoring
If a patient wants pictocin induction when would it not be given
If they are not in active labor its unfavorable
Tocolytics
MAG IV
Nifedopine oral
tubutaline SubQ
AROM contraindication
Herpes
active labor
less than 37 weeks
not engaged
previa
Pt is completed dilated but no urge to push
gravity/upright
What should monitor during induction
Vitals
Fetal Tolerance
Tachocystole
SVE