final labor vaginal delivery advanced concepts in obstetric and pediatric nursing kirkwood communit
final labor vaginal delivery advanced concepts in obstetric and pediatric
delivery advanced concepts
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lOMoAR cPSD| 6374502
FINAL LABOR VAGINAL DELIVERY ADVANCED CONCEPTS IN OBSTETRIC AND
PEDIATRIC NURSING (KIRKWOOD COMMUNITY COLLEGE)
Labor-Vaginal Delivery
UNFOLDING Reasoning
Anne Jones, 17 years old
Primary Concept
Pain
Interrelated Concepts (In order of emphasis)
1. Perfusion
2. Stress
3. Anxiety
4. Reproduction
5. Clinical Judgment
6. Communication
7. Collaboration
NCLEX Client Need Categories Percentage of Items from Each Covered in
Category/Subcategory Case Study
Safe and Effective Care Environment
Management of Care 17-23%
Safety and Infection Control 9-15%
Health Promotion and Maintenance 6-12%
Psychosocial Integrity 6-12%
Physiological Integrity
Basic Care and Comfort 6-12%
Pharmacological and Parenteral Therapies 12-18%
Reduction of Risk Potential 9-15%
Physiological Adaptation 11-17%
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, lOMoAR cPSD| 6374502
History of Present Problem:
Anne is a 17-year-old, gravida 1 para 0 who is 39 weeks gestation and admitted to the labor room for
observation at 1200. She began having contractions three hours ago at 8 to 10-minute intervals with each
contraction lasting 30 seconds. She states her pain is 3/10. Her membranes are intact. On admission, a vaginal
exam indicates cervical dilation is 1 cm, 80% effacement, and 0 station.
After two hours of observation, her cervix is 2-3 cm/ 80% effacement/0 station and contractions are now 4-
5 minutes apart, lasting 60-70 seconds and pain remains 3/10. Fetal lie is longitudinal with a cephalic
presentation. You have her prenatal records from her visits to the office. She is Group Beta Strep (GBS)
positive and received antibiotics at 36 weeks. Her blood type is B-.
Personal/Social History:
Anne’s mother is with her. Anne is not married and the father of the baby is not involved. She appears to be
relaxed although she states she is a bit nervous. She wants a natural non-medicated birth and her mother will
help coach her. She plans on breastfeeding for “awhile”. She attended childbirth preparation classes with her
mother.
What data from the histories are RELEVANT and must be interpreted as clinically significant by the nurse?
(Reduction of Risk Potential)
RELEVANT Data from Present Problem: Clinical Significance:
Anne blood type is B-. The negative mother should recieve a dose of RhoGAM
within 72 hours after given birth to an Rh- positive newborn.
The nurse should inform Anne the reason behind recieving
RhoGAM if Anne’s baby blood type is positive. She should
inform Anne that recieving this shot in the deltoid prevents
sensitization to Rh-positive erythrocytes that may have
entered her bloodstream when the newborn was born.
RELEVANT Data from Social History: Clinical Significance:
Anne is a 17 year old single mother The nurse must assess Anne’s development and
to be. educational level and her support system to best provide
care for her. In Anne’s case, her only support system is her
mother because the father isn’t involved. The nurse should
also maintain a nonjudgmental attitude and assist the single
mother to successfully achieve the psychological tasks of
pregnancy.
Anne is placed on a fetal monitor and
the nurse collects the following strip:
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