MOM/BABY swift river with
100% correct answers ( graded
A+)
Jenny Theriot Scenario 2
Spontaneous rupture of membranes (SROM) confirmed by
+Nitrazine test and collection of fluid with +Fern test. A
Biophysical Profile (BPP) is performed to assess fetal status and
amniotic fluid volume, which is found to be decreased. Amniotic
fluid continues to leak from vagina. Orders are received to admit
to Prenatal Unit and implement Prenatal Premature Rupture of
Membranes (PPROM) protocol. An IV of 1000 ml D5W is started to
ensure adequate hydration. SELECT THE FIRST TWO NURSING
ACTIONS IN THE ORDER THAT THEY SHOULD BE IMPLEMENTED:
1Place bed in Trendelenburg position.Assists in relieving pressure
of fetal head on cervix, preventing premature cervical dilation;
helps in slowing or preventing continuing leaking of amniotic fluid.
Fetal safety is critical.
2Discuss plan of care with patient; answer questions honestly,
especially concerning SROM and implications for preterm labor
and birth - answer ...
Jenny Theriot Scenario 3
Mrs. Theriot continues on complete bedrest in Trendelenburg
position. Upon entering her room she tells you that she "had a
gush of fluid and feels like something came out of her vagina".
She also reports feeling hot and flushed and that she is not sure if
,her baby is moving as much as it was previously. SELECT THE
FIRST TWO NURSING ACTIONS IN THE ORDER THAT THEY SHOULD
BE IMPLEMENTED:
1Inspect perineum.Possible umbilical cord prolapse with gush of
amniotic fluid and small, preterm fetus. Patient states she "feels
like something came out of her vagina." Inspection for prolapsed
cord is the quickest assessment that can be performed.
2Assess FHR for bradycardia.Occult prolapse of umbilical cord
cuts off blood flow to fetus, causing bradycardia and potential
fetal death. Significant changes in the fetal heart rate may
indicate a hidden or occult prolapsed cord.
3Assess vital signs, including - answer ...
Jenny Theriot Scenario 4
Four days later Mrs. Theriot remains on bedrest and continues to
leak small amounts of amniotic fluid. Assessment: BP 110/70
mmHg, P. 78 beats/minute, R 20 breaths/minute, T. 99.4o F. Due
to the potential for developing chorioamnionitis, her healthcare
provider is increasingly concerned about possible pre-term
delivery and writes new orders for her continuing care. SELECT
THE FIRST TWO NURSING ACTIONS IN THE ORDER THAT THEY
SHOULD BE IMPLEMENTED:
1Perform Non-Stress Test (NST) now and bi-weekly BPP and every
shift; teach woman to do Daily Fetal Movement Counts
(DFMCs).Reactive NST indicative of fetal well-being; slowing of
fetal movement is a sign of fetal compromise. Biophysical Profile
(BPP) builds on the NST with fetal ultrasound to evaluate a babys
, heart rate, breathing, movements, muscle tone and amniotic fluid
level. The NST is performed now and each shift to identify signs of
fetal co - answer ...
Jenny Theriot Scenario 5
Mrs. Theriot is weepy and says she is tired of being in bed and in
the hospital. She is also having a hard time resting because of the
multiple interruptions involved with her care. SELECT THE FIRST
TWO NURSING ACTIONS IN THE ORDER THAT THEY SHOULD BE
IMPLEMENTED:
1Encourage vocalization of fear and concerns.Can help allay
anxiety and identify coping behaviors.
2Cluster nursing care activities as much as possible, such as
medication administration, assessments, and vital signs.Promotes
opportunity for woman to obtain rest without interruptions.
3Offer diversional activities: watching TV, reading, crossword
puzzles, small needlecraft activities. Request family to bring
articles from home to "decorate" hospital room.Assists in
refocusing energy; helps cope with decreased mobility; decreases
anxiety; provides some degree of "normalcy" during stressful
time.
4Teach conscious relaxation and bre - answer ....
Clara Guidry Scenario 1
You enter the patient's room. After washing and gloving hands,
you introduce yourself and verify identities of the patient, Mrs.
Clara Guidry and the baby. Assessment findings: Blood pooling
under buttocks with several large clots; fundus boggy and slightly
deviated to the right, 3 cm. above umbilicus; Vital signs: BP
90/60, P 110, R. 20, SAO2 98%, skin color pale, patient alert and
100% correct answers ( graded
A+)
Jenny Theriot Scenario 2
Spontaneous rupture of membranes (SROM) confirmed by
+Nitrazine test and collection of fluid with +Fern test. A
Biophysical Profile (BPP) is performed to assess fetal status and
amniotic fluid volume, which is found to be decreased. Amniotic
fluid continues to leak from vagina. Orders are received to admit
to Prenatal Unit and implement Prenatal Premature Rupture of
Membranes (PPROM) protocol. An IV of 1000 ml D5W is started to
ensure adequate hydration. SELECT THE FIRST TWO NURSING
ACTIONS IN THE ORDER THAT THEY SHOULD BE IMPLEMENTED:
1Place bed in Trendelenburg position.Assists in relieving pressure
of fetal head on cervix, preventing premature cervical dilation;
helps in slowing or preventing continuing leaking of amniotic fluid.
Fetal safety is critical.
2Discuss plan of care with patient; answer questions honestly,
especially concerning SROM and implications for preterm labor
and birth - answer ...
Jenny Theriot Scenario 3
Mrs. Theriot continues on complete bedrest in Trendelenburg
position. Upon entering her room she tells you that she "had a
gush of fluid and feels like something came out of her vagina".
She also reports feeling hot and flushed and that she is not sure if
,her baby is moving as much as it was previously. SELECT THE
FIRST TWO NURSING ACTIONS IN THE ORDER THAT THEY SHOULD
BE IMPLEMENTED:
1Inspect perineum.Possible umbilical cord prolapse with gush of
amniotic fluid and small, preterm fetus. Patient states she "feels
like something came out of her vagina." Inspection for prolapsed
cord is the quickest assessment that can be performed.
2Assess FHR for bradycardia.Occult prolapse of umbilical cord
cuts off blood flow to fetus, causing bradycardia and potential
fetal death. Significant changes in the fetal heart rate may
indicate a hidden or occult prolapsed cord.
3Assess vital signs, including - answer ...
Jenny Theriot Scenario 4
Four days later Mrs. Theriot remains on bedrest and continues to
leak small amounts of amniotic fluid. Assessment: BP 110/70
mmHg, P. 78 beats/minute, R 20 breaths/minute, T. 99.4o F. Due
to the potential for developing chorioamnionitis, her healthcare
provider is increasingly concerned about possible pre-term
delivery and writes new orders for her continuing care. SELECT
THE FIRST TWO NURSING ACTIONS IN THE ORDER THAT THEY
SHOULD BE IMPLEMENTED:
1Perform Non-Stress Test (NST) now and bi-weekly BPP and every
shift; teach woman to do Daily Fetal Movement Counts
(DFMCs).Reactive NST indicative of fetal well-being; slowing of
fetal movement is a sign of fetal compromise. Biophysical Profile
(BPP) builds on the NST with fetal ultrasound to evaluate a babys
, heart rate, breathing, movements, muscle tone and amniotic fluid
level. The NST is performed now and each shift to identify signs of
fetal co - answer ...
Jenny Theriot Scenario 5
Mrs. Theriot is weepy and says she is tired of being in bed and in
the hospital. She is also having a hard time resting because of the
multiple interruptions involved with her care. SELECT THE FIRST
TWO NURSING ACTIONS IN THE ORDER THAT THEY SHOULD BE
IMPLEMENTED:
1Encourage vocalization of fear and concerns.Can help allay
anxiety and identify coping behaviors.
2Cluster nursing care activities as much as possible, such as
medication administration, assessments, and vital signs.Promotes
opportunity for woman to obtain rest without interruptions.
3Offer diversional activities: watching TV, reading, crossword
puzzles, small needlecraft activities. Request family to bring
articles from home to "decorate" hospital room.Assists in
refocusing energy; helps cope with decreased mobility; decreases
anxiety; provides some degree of "normalcy" during stressful
time.
4Teach conscious relaxation and bre - answer ....
Clara Guidry Scenario 1
You enter the patient's room. After washing and gloving hands,
you introduce yourself and verify identities of the patient, Mrs.
Clara Guidry and the baby. Assessment findings: Blood pooling
under buttocks with several large clots; fundus boggy and slightly
deviated to the right, 3 cm. above umbilicus; Vital signs: BP
90/60, P 110, R. 20, SAO2 98%, skin color pale, patient alert and
