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In: Nursing

Mrs. Main. is a 27-y/o gravida 3, para 2, who was admitted at term at 6:30...

Mrs. Main. is a 27-y/o gravida 3, para 2, who was admitted at term at 6:30 p.m. She stated that she had been having contractions 7 to 10 minutes apart since 4 p.m. They last 30 seconds. She also stated that she had been having "a lot of false labor" and hoped that this was "the real thing". Her membranes are intact. Mrs. Main's temperature, pulse and respirations are normal, and her blood pressure is 124/80. The fetal heart tones are 134 and regular. Mrs. Main vaginal assessment is 4/ 80%/ +1 She reported her findings to the doctor and he ordered Fentanyl 50 mcg every hour as needed for pain

2. As Mrs. Main was getting into bed, her membranes ruptured. What is the first thing that should be done when this occurs? Why?

Solutions

Expert Solution

Do a PS/PV... :-

• To assess changes to the cervix (e.g. dilation)
• To assess how far the baby has moved down into the
pelvis
• To determine the presenting part of the baby; whether
the baby is positioned head-first (cephalic) or bottom-
first (breech)
• To check the position of the umbilical cord once the
waters have broken.

Assess the liquor.. :-to check any blood stain , meconium stain.

The condition of the liquor when the membranes rupture:-

The presence of meconium may change the management of the patient as it indicates that fetal distress has been and may still be present.

do a CTG:-to assess  fetal heartbeat and the uterine contractions.An ultrasound can help doctors check how much fluid is surrounding the baby.

Cardiotocography (CTG) measures the baby's heart rate. At the same time it also monitors the contractions in the womb (uterus). CTG is used both before birth (antenatally) and during labour, to monitor the baby for any signs of distress.


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