Case
NURS 3335 Ayana Case Study /Summer 2024 Module B Ayana Case Study
- Course
- NURS 3335 (NURS3335)
- Institution
- Texas Tech University
NURS3335 Perinatal Nursing Concepts. Summer 2024 Module B Ayana Case Study
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Summer 2024 Page 1 of 4 NURS3335Module B Ayana Case Study Perinatal Nursing Concepts
Ayana Singh’s
Low Risk Intrapartum
Story
Follow-up information on antepartum issues and review of information
24yo G2P0010 with iron deficiency anemia; O-(negative), GBS +, Rubella immune, HIV/HepB/RPR
negative. LMP = 9/1
Medications: PNV 1tablet PO daily and ferrous sulfate 325mg PO TID
3rd trimester CBC =WBC 8.8, HBG 12.2, HCT 32%, platelets 190
36-week prenatal visit reveals Ayana desires a natural birth without epidural usage. Ayana has hired
Judy as her doula. Ayana wants to labor in water as much as possible, use a birth ball, and ambulate
freely. She is requesting no IVF and to able to eat freely in labor. She would like a quiet room with dim
lights and for her husband to cut the cord.
Unfolding Case Study Module B Intrapartum Data
June 10 @ 1200:
Ayana calls to the triage unit complaining of contractions that started at 5am. Ayana states,
“Contractions have been coming and going over the past 2 days and are making my stomach hard. I
can’t really focus on anything else. Sometimes they go away for a few hours and then I’ll have several
in one hour. They are irritating but not really painful. I got in the tub this morning and they seemed to
go away for a while.”
June 10 @ 1900:
Ayana’s contractions started occurring in a regular pattern (every 8-10 minutes lasting 40 seconds)
after dinner. She phoned Judy. Judy reassured Ayana she was doing well and went to Ayana’s home to
provide support. At 9pm, Judy encourages Ayana to go to bed and rest and states, “I’ll come back in the
morning or you can call if you need me in the night.”
June 11 @ 0100:
Ayana was able to rest somewhat from 10pm until 1am due to contractions coming and going. She fully
awoke at 0100 after she felt a gush a fluid and thought she may have urinated in bed or her bag of
waters may have ruptured. She went to the bathroom and voided clear urine. Her underwear and linen
reveal clear fluid with evidence of brownish mucous-like secretions. She woke up Mark (husband) and
they drove to the birth unit triage setting. Ayana states, “Ok, I think this is real. The contractions are
getting stronger and I can feel our baby move quite a bit.” Ayana phones Judy and Judy will meet them
in the hospital.
June 11 @ 0130:
Ayana and Mark gave the nurse a copy of their birth plan. The nurse’s notes reveal:
Vital signs stable (VSS)
Electronic fetal monitor (EFM) = Category 1 = FHR 150; moderate variability, x3 accels in 20min
strip.
Contractions (CTX) = q 4 minutes lasting 50 seconds, moderate intensity
Vaginal exam (VE) = 6 cm dilated / 90% effaced / -2 station / anterior position / soft
The nurse phones Joanne Thompson CNM and receives orders. In addition to standard labor admission
orders, Penicillin G is ordered to be administered IV per CDC GBS protocol.
June 11 @ 0630:
Ayana frequently repositions herself in bed and states, “I don’t know if I can do this. The contractions
are so hard and I’m tired.” Mark reassures her. The nurse’s notes reveal:
VSS
EFM = Category 1
CTX = q 2 minutes lasting 80-90 seconds, firm intensity
VE = 9 cm dilated / 100% effaced / 0 station / LOT
June 11 @ 0712:
Ayana experienced a spontaneous vaginal delivery (SVD) and birthed a male singleton infant (Todd)
sustaining a 2nd degree perineal laceration. Todd was dried, stimulated, suctioned via bulb suction at
time of birth and was placed on Ayana’s bare chest. Mark, standing by Ayana’s side, is able to cut the
cord. Apgars are 8/9 respectively.
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