Swiftriver Maternity actual
expert curated questions and
answers
Jessica Wu, 35-year-old Asian female, G3 T2 P2 A0 L2, 35 weeks
gestation. NKDA. Previous pregnancies uncomplicated but
Cesarean births due to persistent breech position. Smoker x 15
years but states she "cut back to 3 cigarettes/day during her
pregnancies." Reports that she started smoking during college.
States started having moderate amount of bright red bleeding
about 0800. Came to the hospital after dropping the older
children at school (5 and 7 years old). She has called her husband
and he is meeting her at the hospital because he was already at
work. It is now 0945. She is anxious about the bleeding. States
she "never had anything like this with her other pregnancies!"
Denies pain, contractions, or leaking of amniotic fluid. - answer
Educational Needs- Increased
Fall Risk- Increased
Health Change- Increased
Pain Level- Normal
Psychological Needs- Increased
Psychological Needs- Normal
Kesha Jackson, Patient is a G1P0, gestational age of 33.1. She
came in complaining of contractions for 2 hours that are now
every 5 mins. She is unsure about rupture of membranes, denying
,vaginal bleeding and recent intercourse. She states the baby is
active. She rates her pain an 8/10. Her current vital signs are 98.1
F, 36.7 C, 92 BPM, 16 breaths/min, 122/64 mmHg, 99% on room
air. The fetal heart rate is 135 baseline but is not yet reactive.
Cervical exam reveals that she is not dilated or effaced, and the
baby's head is not engaged in the pelvis. She has no medical
history and NKA. In obtaining her history, it was learned that she
is 15 years old, currently homeless, and has been staying with
various friends. She does have some supplies including diapers,
wipes, and some clothing that she received from a friend. She
expresses the desire to take her baby home with her. She is
receptive to teaching and assistance sh - answer Educational
Needs- Increased
Fall Risk- Increased
Health Change- Increased
Pain Level- Increased
Psychological Needs- Increased
Sensorium- Normal
Maria Sanchez, 20-year-old female, G1 P1 L1, 39 weeks gestation.
Pregnancy uncomplicated. O+, Rubella immune, Group B Strep
negative. NKDA. 12-hour 1st stage, 1 hour 2nd stage, 10 minute
3rd stage. Spontaneous vaginal delivery with 1st degree perineal
laceration one hour ago. Vital signs stable; fundus firm, midline, at
umbilicus; Lochia rubra moderate, no clots; Up to bathroom x1-
500 mL, no dysuria, instructed on peri-care; Legs still a little
"tingly" but able to bear weight with assist X2. Pain level 3/10- ice
to perineum with relief. Neonate male- Juan- 3500 g; Apgar 8 & 9;
T 36.8 C, 98.2 F; AP 156 beats/minute, regular; R 52
breaths/minute, irregular. Skin-to-skin with mother for first hour.
Beginning to show hunger cues. Their plan is do both breast and
, bottle feeding; "las dos cosas." Maria's husband Raul is a quiet
presence. Her mother, grandmother, and older sister were Maria's
support persons in labor. Mar - answer Educational: Increased
Fall Risk: Increased
Health changes: Increased
Pain Level: Increased
Psychological Needs: Increased
Sensorium: Normal
Clara Guidry, Patient is a 34 y/o G5P4 who gave birth to a 9lb. 3
oz male infant following a 12-hour elective oxytocin induction of
labor. She had an uncomplicated labor, epidural anesthesia and a
rapid second stage, no episiotomy or perineal lacerations.
Indwelling urinary catheter was removed prior to delivery. She is
now one hour postpartum and is breastfeeding her baby. An IV of
1000 mL Lactated Ringers is infusing at KVO rate with an infusion
of Lactated Ringers with oxytocin 20 Units infusing IVPB at 125
mL/hour. Upon entering her room, she tells you that she "feels
wet", and may have urinated on herself since she is still numb
from the epidural and unable to move legs. Your assessment
reveals blood pooling under buttocks onto the underpads with
numerous large clots. She is anxious, appears pale, and
complains of feeling light-headed. Her husband is at her bedside.
- answer Educational: Increased
Fall Risk: Increased
Health changes: Increased
Pain Level: Normal
Psychological Needs: Increased
Sensorium: Increased
expert curated questions and
answers
Jessica Wu, 35-year-old Asian female, G3 T2 P2 A0 L2, 35 weeks
gestation. NKDA. Previous pregnancies uncomplicated but
Cesarean births due to persistent breech position. Smoker x 15
years but states she "cut back to 3 cigarettes/day during her
pregnancies." Reports that she started smoking during college.
States started having moderate amount of bright red bleeding
about 0800. Came to the hospital after dropping the older
children at school (5 and 7 years old). She has called her husband
and he is meeting her at the hospital because he was already at
work. It is now 0945. She is anxious about the bleeding. States
she "never had anything like this with her other pregnancies!"
Denies pain, contractions, or leaking of amniotic fluid. - answer
Educational Needs- Increased
Fall Risk- Increased
Health Change- Increased
Pain Level- Normal
Psychological Needs- Increased
Psychological Needs- Normal
Kesha Jackson, Patient is a G1P0, gestational age of 33.1. She
came in complaining of contractions for 2 hours that are now
every 5 mins. She is unsure about rupture of membranes, denying
,vaginal bleeding and recent intercourse. She states the baby is
active. She rates her pain an 8/10. Her current vital signs are 98.1
F, 36.7 C, 92 BPM, 16 breaths/min, 122/64 mmHg, 99% on room
air. The fetal heart rate is 135 baseline but is not yet reactive.
Cervical exam reveals that she is not dilated or effaced, and the
baby's head is not engaged in the pelvis. She has no medical
history and NKA. In obtaining her history, it was learned that she
is 15 years old, currently homeless, and has been staying with
various friends. She does have some supplies including diapers,
wipes, and some clothing that she received from a friend. She
expresses the desire to take her baby home with her. She is
receptive to teaching and assistance sh - answer Educational
Needs- Increased
Fall Risk- Increased
Health Change- Increased
Pain Level- Increased
Psychological Needs- Increased
Sensorium- Normal
Maria Sanchez, 20-year-old female, G1 P1 L1, 39 weeks gestation.
Pregnancy uncomplicated. O+, Rubella immune, Group B Strep
negative. NKDA. 12-hour 1st stage, 1 hour 2nd stage, 10 minute
3rd stage. Spontaneous vaginal delivery with 1st degree perineal
laceration one hour ago. Vital signs stable; fundus firm, midline, at
umbilicus; Lochia rubra moderate, no clots; Up to bathroom x1-
500 mL, no dysuria, instructed on peri-care; Legs still a little
"tingly" but able to bear weight with assist X2. Pain level 3/10- ice
to perineum with relief. Neonate male- Juan- 3500 g; Apgar 8 & 9;
T 36.8 C, 98.2 F; AP 156 beats/minute, regular; R 52
breaths/minute, irregular. Skin-to-skin with mother for first hour.
Beginning to show hunger cues. Their plan is do both breast and
, bottle feeding; "las dos cosas." Maria's husband Raul is a quiet
presence. Her mother, grandmother, and older sister were Maria's
support persons in labor. Mar - answer Educational: Increased
Fall Risk: Increased
Health changes: Increased
Pain Level: Increased
Psychological Needs: Increased
Sensorium: Normal
Clara Guidry, Patient is a 34 y/o G5P4 who gave birth to a 9lb. 3
oz male infant following a 12-hour elective oxytocin induction of
labor. She had an uncomplicated labor, epidural anesthesia and a
rapid second stage, no episiotomy or perineal lacerations.
Indwelling urinary catheter was removed prior to delivery. She is
now one hour postpartum and is breastfeeding her baby. An IV of
1000 mL Lactated Ringers is infusing at KVO rate with an infusion
of Lactated Ringers with oxytocin 20 Units infusing IVPB at 125
mL/hour. Upon entering her room, she tells you that she "feels
wet", and may have urinated on herself since she is still numb
from the epidural and unable to move legs. Your assessment
reveals blood pooling under buttocks onto the underpads with
numerous large clots. She is anxious, appears pale, and
complains of feeling light-headed. Her husband is at her bedside.
- answer Educational: Increased
Fall Risk: Increased
Health changes: Increased
Pain Level: Normal
Psychological Needs: Increased
Sensorium: Increased
