OB NURS 306 Maternal and Newborn STUDY GUIDE EXAM
2022/2023 UPDATE GRADED A+
History of Present Illness (HPI), Pathophysiology of Admitting Dx (Cite Refrences),
Medical, Surgical, Social History What brought the PT to the hospital? What events lead
up to this? What Happened when they got to the hospital?
V.O is a 31-year-old female (she/her) who complained of severe pain and feeling a
significant amount of abdominal pressure. V.O. is G2T11P0A0L1. The patient explained that
she was having a good day and even had her baby shower party that day. While at the patient's
baby shower, she began to feel abdominal pain, pressure, and contractions, so she felt like she
needed to go to the hospital. The patient was 40 weeks of gestation when she arrived at the
hospital
experiencing these symptoms. She was assessed by the staff and was admitted to the hospital; the
patient had dilated 0.5 cm and was 50% effaced. The patient's baby was delivered the following
morning, July 10th, 2022, at 9:58 am via repeat c-section and also getting a bilateral tubal
ligation. The baby and mother are fine, there were complications during labor, and they are
now recovering.
Pathophysiology of Admitting Dx: Active labor with a repeat c-section.
Labor is a process where it is divided into three main stages, “the first stage starts when
labor begins and ends with full cervical dilation and effacement” (Hutchison et al., 2022). The
second stage begins with “cervical dilation and ends with the delivery of the fetus,” and the last
stage, which is the third stage, begins once the “fetus is delivered and ends when the placenta is
delivered” (Hutchison et al., 2022).
When going into labor, women can present with various signs/ symptoms, “common
chief complaints include painful contractions, vaginal bleeding/ bloody show, and fluid leakage
OB NURS 306 Maternal and Newborn STUDY GUIDE EXAM
2022/2023 UPDATE GRADED A+
,OB NURS 306 Maternal and Newborn STUDY GUIDE EXAM
2022/2023 UPDATE GRADED A+
from the vagina” (Hutchison et al., 2022). The doctor will determine if the mother is in labor by
doing an examination which will involve looking “for signs of rupture of membranes such as
amniotic fluid” and testing it, as well as looking for signs of cervical dilation, and even an
ultrasound to determine fetal heart rate/ sounds and “to confirm the presentation and positioning
of the” fetus (Hutchison et al., 2022).
Cesarían section deliveries, especially in recent years, have become more frequent,
“cesarean section is the most common surgery performed in the United States,” and it is
estimated that there are “over a million cesarean deliveries performed every year” (Sung &
Mahdy, 2022). Cesarean section is considered to be major surgery; it involves the “fetal
delivery through an open abdominal incision (laparotomy) and an incision in the uterus
(hysterectomy)” (Sung & Mahdy, 2022). Cesarían section deliveries can happen for many
reasons; the main reason, to put it simply, is that “a vaginal birth would be dangerous” to either
the mother, baby,
or even both, so the best course of action would be to deliver the baby via Cesarean section
(Sung & Mahdy, 2022). There are other indications as well for cesarian section deliveries,
such as “prior cesarean delivery, umbilical cord prolapse, herpes simplex or HIV infection,
malpresentation and even failed operative vaginal delivery,” which can all lead to needing a
cesarean section delivery (Sung & Mahdy, 2022).
The patient had a previous baby via cesarean section delivery and now had a scheduled
cesarian section delivery, the patient had her baby the following day via c-section.
Medical History: Past Diagnosed Medical Problems:
The patient was diagnosed with Lactose Intolerance 2 years ago. Lactose Intolerance is
OB NURS 306 Maternal and Newborn STUDY GUIDE EXAM
2022/2023 UPDATE GRADED A+
,OB NURS 306 Maternal and Newborn STUDY GUIDE EXAM
2022/2023 UPDATE GRADED A+
a “clinical syndrome that manifests with characteristic signs and symptoms upon consuming
food substances containing lactose” (Malik & Panuganti, 2022). When someone is Lactose
intolerant and consumes food items containing lactose, the person can experience symptoms that
“depends on the amount of lactose consumed, the residual lactase function and the small bowel
transit time” (Malik & Panuganti, 2022). The person experiences different kinds of symptoms,
but most commonly, people can experience signs/ symptoms such as “diarrhea, abdominal
bloating, abdominal pain, nausea and vomiting, fullness and flatulence” (Malik & Panuganti,
2022). The Pathophysiology of Lactose intolerance is related to the lactase enzyme that’s found
in “the brush border of the small intestinal mucosa,,” and any “deficiency of lactase results in the
presence of unabsorbed lactose within the bowel” (Malik & Panuganti, 2022). Treatment and
management of those with lactose intolerance are “limiting the dietary intake of lactose by
avoiding the intake of lactose contained products” because this will help with the symptoms of
lactose intolerance, avoiding things like “milk, whey, butter, cream, ice cream” will overall
help with having symptoms (Malik & Panuganti, 2022).
Surgical History: Past diagnosed Surgical Problems:
❖ Cesarean Section:
The patient had a cesarean section when she delivered her first baby. A c-section birth is
“fetal delivery through an open abdominal incision (laparotomy) and an incision in the uterus
(hysterectomy)” (Sung & Mahdy, 2022). There are several indications for a patient to end up
receiving a c-section; these indications include “pelvic abnormalities, the problem with the
placenta, multiple gestation pregnancy, active herpes simplex, nonreassuring fetal heart rate,
malpresentation of the fetus, and” any serious situation that could end up harming the mother and
or the fetus (Puia, n.d.). The patient had an emergency c-section because the fetal heart rate
OB NURS 306 Maternal and Newborn STUDY GUIDE EXAM
2022/2023 UPDATE GRADED A+
, OB NURS 306 Maternal and Newborn STUDY GUIDE EXAM
2022/2023 UPDATE GRADED A+
dropped to a very low rate, resulting in the baby being delivered via emergency c-section at 37
weeks of gestation.
❖ Bilateral Tubal Ligation:
The patient received a Bilateral tubal ligation after her most recent cesarean section
delivery. Bilateral tubal ligation “is a highly safe and effective form of permanent contraception
for” people with uterus’ who do not want to have any more children (Tesfaw et al., 2022). Those
who do not want to carry and deliver any more fetuses’ and often times look into tubal ligation as
a form of permanent birth control. However, there are those who have a Bilateral tubal ligation
that would be contraindicated in those “patients have a desire for future childbearing” Tesfaw et
al., 2022).
Social History: Smoking/ Tobacco/ E-Cigarette/ Marijuana use/ Alcohol/ Elicit drug use:
When asked for a history of any smoking, such as Marijuana, E-Cigarettes, tobacco, and
so on, the patient denied partaking in any activity that involved smoking. She explained that
smoking was not interesting to her. The patient denies any illicit drug use. The patient said that
she occasionally drinks when she goes to family get-togethers, but it is not often. She said she
would drink at most once a month before she was pregnant.
Cultural considerations, ethnicity, occupation, religion, family support, insurance,
socioeconomic/ cultural/ spiritual orientation, and psychosocial considerations/ concerns:
include the following social determinants of health (SDOH):
V.O. is a 31-year-old Mexican-American female. She was born and raised in Los
Angeles, California. She was raised by both of her parents and her sister, she said her
parents worked all the time to be able to afford food and a place to live. She was raised
OB NURS 306 Maternal and Newborn STUDY GUIDE EXAM
2022/2023 UPDATE GRADED A+
2022/2023 UPDATE GRADED A+
History of Present Illness (HPI), Pathophysiology of Admitting Dx (Cite Refrences),
Medical, Surgical, Social History What brought the PT to the hospital? What events lead
up to this? What Happened when they got to the hospital?
V.O is a 31-year-old female (she/her) who complained of severe pain and feeling a
significant amount of abdominal pressure. V.O. is G2T11P0A0L1. The patient explained that
she was having a good day and even had her baby shower party that day. While at the patient's
baby shower, she began to feel abdominal pain, pressure, and contractions, so she felt like she
needed to go to the hospital. The patient was 40 weeks of gestation when she arrived at the
hospital
experiencing these symptoms. She was assessed by the staff and was admitted to the hospital; the
patient had dilated 0.5 cm and was 50% effaced. The patient's baby was delivered the following
morning, July 10th, 2022, at 9:58 am via repeat c-section and also getting a bilateral tubal
ligation. The baby and mother are fine, there were complications during labor, and they are
now recovering.
Pathophysiology of Admitting Dx: Active labor with a repeat c-section.
Labor is a process where it is divided into three main stages, “the first stage starts when
labor begins and ends with full cervical dilation and effacement” (Hutchison et al., 2022). The
second stage begins with “cervical dilation and ends with the delivery of the fetus,” and the last
stage, which is the third stage, begins once the “fetus is delivered and ends when the placenta is
delivered” (Hutchison et al., 2022).
When going into labor, women can present with various signs/ symptoms, “common
chief complaints include painful contractions, vaginal bleeding/ bloody show, and fluid leakage
OB NURS 306 Maternal and Newborn STUDY GUIDE EXAM
2022/2023 UPDATE GRADED A+
,OB NURS 306 Maternal and Newborn STUDY GUIDE EXAM
2022/2023 UPDATE GRADED A+
from the vagina” (Hutchison et al., 2022). The doctor will determine if the mother is in labor by
doing an examination which will involve looking “for signs of rupture of membranes such as
amniotic fluid” and testing it, as well as looking for signs of cervical dilation, and even an
ultrasound to determine fetal heart rate/ sounds and “to confirm the presentation and positioning
of the” fetus (Hutchison et al., 2022).
Cesarían section deliveries, especially in recent years, have become more frequent,
“cesarean section is the most common surgery performed in the United States,” and it is
estimated that there are “over a million cesarean deliveries performed every year” (Sung &
Mahdy, 2022). Cesarean section is considered to be major surgery; it involves the “fetal
delivery through an open abdominal incision (laparotomy) and an incision in the uterus
(hysterectomy)” (Sung & Mahdy, 2022). Cesarían section deliveries can happen for many
reasons; the main reason, to put it simply, is that “a vaginal birth would be dangerous” to either
the mother, baby,
or even both, so the best course of action would be to deliver the baby via Cesarean section
(Sung & Mahdy, 2022). There are other indications as well for cesarian section deliveries,
such as “prior cesarean delivery, umbilical cord prolapse, herpes simplex or HIV infection,
malpresentation and even failed operative vaginal delivery,” which can all lead to needing a
cesarean section delivery (Sung & Mahdy, 2022).
The patient had a previous baby via cesarean section delivery and now had a scheduled
cesarian section delivery, the patient had her baby the following day via c-section.
Medical History: Past Diagnosed Medical Problems:
The patient was diagnosed with Lactose Intolerance 2 years ago. Lactose Intolerance is
OB NURS 306 Maternal and Newborn STUDY GUIDE EXAM
2022/2023 UPDATE GRADED A+
,OB NURS 306 Maternal and Newborn STUDY GUIDE EXAM
2022/2023 UPDATE GRADED A+
a “clinical syndrome that manifests with characteristic signs and symptoms upon consuming
food substances containing lactose” (Malik & Panuganti, 2022). When someone is Lactose
intolerant and consumes food items containing lactose, the person can experience symptoms that
“depends on the amount of lactose consumed, the residual lactase function and the small bowel
transit time” (Malik & Panuganti, 2022). The person experiences different kinds of symptoms,
but most commonly, people can experience signs/ symptoms such as “diarrhea, abdominal
bloating, abdominal pain, nausea and vomiting, fullness and flatulence” (Malik & Panuganti,
2022). The Pathophysiology of Lactose intolerance is related to the lactase enzyme that’s found
in “the brush border of the small intestinal mucosa,,” and any “deficiency of lactase results in the
presence of unabsorbed lactose within the bowel” (Malik & Panuganti, 2022). Treatment and
management of those with lactose intolerance are “limiting the dietary intake of lactose by
avoiding the intake of lactose contained products” because this will help with the symptoms of
lactose intolerance, avoiding things like “milk, whey, butter, cream, ice cream” will overall
help with having symptoms (Malik & Panuganti, 2022).
Surgical History: Past diagnosed Surgical Problems:
❖ Cesarean Section:
The patient had a cesarean section when she delivered her first baby. A c-section birth is
“fetal delivery through an open abdominal incision (laparotomy) and an incision in the uterus
(hysterectomy)” (Sung & Mahdy, 2022). There are several indications for a patient to end up
receiving a c-section; these indications include “pelvic abnormalities, the problem with the
placenta, multiple gestation pregnancy, active herpes simplex, nonreassuring fetal heart rate,
malpresentation of the fetus, and” any serious situation that could end up harming the mother and
or the fetus (Puia, n.d.). The patient had an emergency c-section because the fetal heart rate
OB NURS 306 Maternal and Newborn STUDY GUIDE EXAM
2022/2023 UPDATE GRADED A+
, OB NURS 306 Maternal and Newborn STUDY GUIDE EXAM
2022/2023 UPDATE GRADED A+
dropped to a very low rate, resulting in the baby being delivered via emergency c-section at 37
weeks of gestation.
❖ Bilateral Tubal Ligation:
The patient received a Bilateral tubal ligation after her most recent cesarean section
delivery. Bilateral tubal ligation “is a highly safe and effective form of permanent contraception
for” people with uterus’ who do not want to have any more children (Tesfaw et al., 2022). Those
who do not want to carry and deliver any more fetuses’ and often times look into tubal ligation as
a form of permanent birth control. However, there are those who have a Bilateral tubal ligation
that would be contraindicated in those “patients have a desire for future childbearing” Tesfaw et
al., 2022).
Social History: Smoking/ Tobacco/ E-Cigarette/ Marijuana use/ Alcohol/ Elicit drug use:
When asked for a history of any smoking, such as Marijuana, E-Cigarettes, tobacco, and
so on, the patient denied partaking in any activity that involved smoking. She explained that
smoking was not interesting to her. The patient denies any illicit drug use. The patient said that
she occasionally drinks when she goes to family get-togethers, but it is not often. She said she
would drink at most once a month before she was pregnant.
Cultural considerations, ethnicity, occupation, religion, family support, insurance,
socioeconomic/ cultural/ spiritual orientation, and psychosocial considerations/ concerns:
include the following social determinants of health (SDOH):
V.O. is a 31-year-old Mexican-American female. She was born and raised in Los
Angeles, California. She was raised by both of her parents and her sister, she said her
parents worked all the time to be able to afford food and a place to live. She was raised
OB NURS 306 Maternal and Newborn STUDY GUIDE EXAM
2022/2023 UPDATE GRADED A+
