Patient IntroductionLocation: Labor and Birthing RoomTime: 2220 hoursSituation: Brenda Patton is an 18-year-old patient, G1P0 at 38 2/7 weeks of gestation, admitted to the Labor and Delivery Unit at 2145 for rupture of membranes and uterine contractions. She was sent from OB-GYN office by the midwife, who confirmed rupture of membranes via sterile speculum exam with positive ferning, and the patient’s vaginal exam was 4 cm, 90%, -1 station. The patient reported SROM at around 9 a.m. this morning with clear fluid.
She has phoned her parent and her partner to inform them of her admission. Admission intrapartum orders have been initiated, initial labs have been drawn, and an IV catheter has been placed in her forearm.Background: Brenda Patton’s pregnancy has been uncomplicated. She does not have any significant medical concerns and does not have any medication allergies. The patient wishes to have a natural birth without medication.Assessment: Upon our initial assessment, the patient was 4 cm dilated, 90% effaced, and a -1 station, and the vaginal fluid was nitrazine positive. The provider has been notified, and prenatal records have been pulled. The lab report indicates that the patient’s group B strep vaginal-rectal culture taken at 36 weeks was positive.Recommendation: Complete the admission process, review the lab results, and initiate treatment of group B strep.
Maternity Nursing Care
Ricci, S., Kyle, T., and Carman, S. (2021). Maternity and Pediatric Nursing, 4th Edition.Medical-Surgical Nursing Care
Group B Streptococcus, Chapter 20, pp. 739-740
Medical-Surgical Nursing Care
Continuous External Monitoring, Chapter 14, p. 469 – 480
Medical-Surgical Nursing Care
Promoting Comfort and Providing Pain Management During Labor, Chapter 14, pp. 480-487
Medical-Surgical Nursing Care
Assessing the Woman Upon Admission, Chapter 14, pp. 490-497
Medical-Surgical Nursing Care
Overview of a Woman in the Active Phase of the First Stage of Labor, Chapter 14, p. 497-499
Medical-Surgical Nursing Care
Pregnant Adolescent, Chapter 20, p. 745
Diagnostic Testing
Expert Clinical Content from Lippincott AdvisorPharmacology
White blood cell count and differential
Pharmacology
Expert Clinical Content from Lippincott AdvisorPharmacology
Penicillin G potassium
Pharmacology
Ondansetron
Procedures
Expert Clinical Content from Lippincott Procedures
Pharmacology
Fetal monitoring