Scenario: History of Present Problem: Luella Jones

Scenario: History of Present Problem: Luella Jones is a 25-year-old female patient G1P0 who is currently 40 3/7 weeks gestation. She is admitted to the hospital for an induction of labor due to post-date. She is positive for Group Beta streptococcus and receiving IV antibiotics per protocol. She is 65 inches (162.5 cm). Her pre-pregnancy weight was 115 pounds (52.3 kg). She gained 15 pounds (6.8 kg) during this pregnancy. She just had spontaneous rupture of membranes with a moderate amount of thick meconium fluid. The nurse performed a vaginal check, and her cervical exam shows dilated to 4 cm, 80% percent effaced and -1 station. Pitocin is infusing at 6 mU/minute intravenously. Personal/Social History: Luella lives alone and is no longer involved with the father of her baby. Her family support is limited to her older sister. She smokes one pack of cigarettes a day and has not had a job for over a year and states money is tight. She admits to not eating very healthy during the pregnancy because it is easier to grab chips and pop than cook. She missed a few of her prenatal visits due to transportation issues and did not attend any prenatal classes. Her sister is present as her support person during labor and delivery. 1- What data from the histories are RELEVANT and must be interpreted as clinically significant by the nurse? List 8 items from her history that are relevant and list the clinical significance of each. Labor continues: Luella continues to labor. As labor progresses, Luella receives an epidural for pain control. After receiving the epidural, Luella’s blood pressure drops to 76/42. What most likely caused the drop in Luella’s Bp? Luella’s Bp remains low which causes fetal bradycardia to 70 bpm. What interventions should be done? (list 4) The fetal heart rate does not increase with interventions. The safest plan for delivery for Luella would be which route? At delivery a boy is born. The baby at 1 minute of life is not crying but is making slight grunty noises, is completely blue in color, HR less than 100, is flaccid, and is whimpers after stimulation.v What is the 1-minute Apgar, explain your scoring. At 5 minutes the baby is crying with stimulation, moving his extremities, mostly pink, HR >100, grunting when not stimulated. What is the 5-minute Apgar, explain

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