.Fetal Distress/Cesarean Section RAPID Reasoning Solved
Fetal Distress/Cesarean Section
RAPID Reasoning
Luella Jones, 25 years old
Primary Concept
Perfusion
Interrelated Concepts (In order of emphasis)
Reproduction
Clinical Judgment
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%
© 2018 Keith Rischer/www.KeithRN.com
, .Fetal Distress/Cesarean Section RAPID Reasoning Solved
RAPID Reasoning Case Study
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 to be induced for being 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 cervix is 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.
What data from the histories are RELEVANT and must be interpreted as clinically significant by the nurse?
RELEVANT Data from Present Problem: Clinical Significance:
-She’s G1P0, she is term, has not given birth -Positive for GBS, needs penicillin, unless she is allergic.
yet but she is pregnant -lack of weight gain might result in much smaller baby.
-She only gained 15 lbs.
-Positive for GBS
-She is overdue
RELEVANT Data from Social History: Clinical Significance:
-No relationship with the father of the baby. - This could result in mal-attachment
-Family support limited -This could cause growth issues with baby due to poor nutrition and also
-Did not eat very healthy during pregnancy caused to the smoking
-Did not attend prenatal classes -No support system could lead to negligence for the baby.
-Sister is support person during delivery
-Smokes
-Money is tight
Patient Care Begins:
Current VS: P-Q-R-S-T Pain Assessment:
T: 99.9 F/37.7 C (oral) Provoking/Palliative: Uterine contractions
P: 90 (regular) Quality: Severe cramping
R: 18 (regular) Region/Radiation: Low pelvis
BP: 118/68 Severity: 5/10
O2 sat: 98 % RA Timing: With uterine contractions
What VS data are RELEVANT and must be interpreted as clinically significant by the nurse?
RELEVANT VS Data: Clinical Significance:
Fetal Distress/Cesarean Section
RAPID Reasoning
Luella Jones, 25 years old
Primary Concept
Perfusion
Interrelated Concepts (In order of emphasis)
Reproduction
Clinical Judgment
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%
© 2018 Keith Rischer/www.KeithRN.com
, .Fetal Distress/Cesarean Section RAPID Reasoning Solved
RAPID Reasoning Case Study
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 to be induced for being 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 cervix is 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.
What data from the histories are RELEVANT and must be interpreted as clinically significant by the nurse?
RELEVANT Data from Present Problem: Clinical Significance:
-She’s G1P0, she is term, has not given birth -Positive for GBS, needs penicillin, unless she is allergic.
yet but she is pregnant -lack of weight gain might result in much smaller baby.
-She only gained 15 lbs.
-Positive for GBS
-She is overdue
RELEVANT Data from Social History: Clinical Significance:
-No relationship with the father of the baby. - This could result in mal-attachment
-Family support limited -This could cause growth issues with baby due to poor nutrition and also
-Did not eat very healthy during pregnancy caused to the smoking
-Did not attend prenatal classes -No support system could lead to negligence for the baby.
-Sister is support person during delivery
-Smokes
-Money is tight
Patient Care Begins:
Current VS: P-Q-R-S-T Pain Assessment:
T: 99.9 F/37.7 C (oral) Provoking/Palliative: Uterine contractions
P: 90 (regular) Quality: Severe cramping
R: 18 (regular) Region/Radiation: Low pelvis
BP: 118/68 Severity: 5/10
O2 sat: 98 % RA Timing: With uterine contractions
What VS data are RELEVANT and must be interpreted as clinically significant by the nurse?
RELEVANT VS Data: Clinical Significance:
