Maternity Case 2: Brenda Patton - vSim
for Nursing, Feedback Log & CONCEPT
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The nurse is providing education to a patient about group B streptococcus (GBS) during
a prenatal visit. This education session would include which statement from the
following choices?
- Between 35 and 37 weeks' gestation, GBS screening is done to detect this bacteria.
What are the possible complications that a newborn can acquire from the mother with a
positive GBS status during the birthing process?
- Pneumonia, sepsis, meningitis.
The nurse is carrying out a provider's order to administer an antibiotic by intravenous
secondary infusion. In what order would the nurse complete the steps below?
- 1.) Verify the provider's order
2.) Check the patient's allergy status
3.) Confirm patient identity with two identifiers
4.) Explain the procedure to the patient
5.) Assess the patient's IV site
6.) Check the rights of medication administration
A laboring woman with a positive GBS status was admitted to the hospital with ruptured
fetal membranes. What maternal temperature reading would be reported to the primary
healthcare provider?
- 100.8 F
A patient is admitted in active labor, and she has a right occipitoanterior (ROA)
presentation. The nurse is applying the external fetal monitor. Where does the nurse
place the fetal ultrasound transducer?
- Right lower quadrant.
A patient with ruptured fetal membranes has been in labor for several hours. What signs
and symptoms of intrapartum infection would the nurse report to the primary medical
provider?
- Cloudy, foul-smelling vaginal discharge. Fetal heart rate at 168 bpm.
A primigravida is admitted to labor and delivery. A review of her prenatal records
revealed a urinanalysis with a negative WBC count, RBC count, leukoesterase, and
nitrates, and positive glucose and ketones; a serology report that was positive for
hepatitis B surface antigens; and a microbiology report positive for GBS. For which of
the following reasons would the nurse initiate intrapartum prophylaxis antibiotics?
- Positive GBS culture.
, What range is considered a normal baseline FHR?
- 110 to 160 bpm
In what stage and phase of labor is a woman experiencing contractions every 5-10
minutes and with a vaginal examination of 2cm dilation, 50% effacement, and -2
station?
- First stage, latent phase
The nurse needs to administer an IV dose of Pencillin G potassium to a laboring
woman. This client has a peripheral IV lock. Which of the following is the safest method
to give this dose of medication? - Check IV for patency with 3mL of 0.9% normal saline
and attach the dose through intravenous piggyback (IVPB)
Brenda Patton was admitted in active labor 5 hours ago and she has NKDA. Her GBS
was positive. There are orders to receive intrapartum antibiotics. Which of the following
would the nurse anticipate administering to Ms. Patton? - Penicillin G potassium, 5
million units
After a laboring patient with a positive GBS status received a dose of penicillin, she
complains of itchy bumps and difficulty breathing, and her blood pressure is 102/52
mmHg. What do you think is occurring? - Anaphylaxis.
The nurse is interpreting the external fetal monitoring strips for Ms. Patton while she is
in active labor. Which findings indicate that the fetus is tolerating labor? - Moderate
variability, accelerations, early decelerations.
Ms. Patton is a primigravida at 38 2/7 weeks' gestation, and she has a positive GBS
status. The nurse received report that this patient's last vaginal exam showed 50%
effacement, 4cm dilation, and -2 station. Ms. Patton stated that she thinks her water
broke sometime this morning. What initial action would the nurse take? - Ask the patient
to estimate the time when she thought her water broke.
Ms. Patton was admitted in labor 2 hours ago, and it was determined that her
membranes have ruptured. Which of the following maternal assessments would have
the highest priority? - Temperature
Ms. Patton has a positive GBS status. Her mother asks the nurse, "Why does my
daughter need antibiotic? She wants a natural birth." What is the best response by the
nurse? - This antibiotic will reduce the risk of the baby getting an infection from your
daughter.
The nurse interprets the initial assessment data for Ms. Patton, who was admitted in
active labor. Which of the following assessments would the nurse communicate to the
provider? - Maternal temperature of 100.6 F
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