Case Study:Patient Profile:Name: Cece ParekhAge: 29 years ol…
Questions
Cаse Study:Pаtient Prоfile:Nаme: Cece ParekhAge: 29 years оldGravida: 2, Para: 1Estimated Gestatiоnal Age: 39 weeks + 2 daysAdmission: Labor and DeliveryCece Parekh is a 29-year-old G2P1 patient who is admitted to the labor and delivery unit at 39 weeks and 2 days for spontaneous onset of labor. She had an uncomplicated pregnancy with consistent prenatal care. Upon admission, she is 4 cm dilated, 80% effaced, and the fetal head is at -1 station. Her membranes are intact, and she is experiencing contractions every 5 minutes, lasting 45 seconds.Vital Signs on Admission:Temperature: 98.6°F (37°C)Pulse: 82 bpmRespirations: 18 breaths per minuteBlood Pressure: 128/80 mmHgFetal Heart Rate (FHR): 145 bpm, baseline with moderate variabilityHer last delivery was vaginal without complications. Cece expresses anxiety about labor pain but desires a natural birth without an epidural if possible.Assessment:The nurse performs Leopold's maneuvers and determines that the baby is in a cephalic presentation. The fetal heart rate is monitored continuously, showing a baseline of 145 bpm with moderate variability and occasional early decelerations.What is the priority nursing action for Cece upon admission to the labor and delivery unit?a. Administer an IV analgesicb. Assess the fetal heart rate and contraction patternc. Encourage Cece to start pushingCece expresses concern about managing pain without an epidural. What non-pharmacological pain relief interventions could the nurse offer her?d. Encourage early administration of opioidse. Offer frequent position changes and breathing exercisesf. Suggest epidural anesthesia early in laborCece's membranes rupture spontaneously, and the nurse notes green-tinged fluid. FHR remains within normal limits. What is the next priority nursing action?g. Turn the patient to the left lateral positionh. Document the color and amount of amniotic fluidi. Prepare for emergency deliveryAs labor progresses, Cece reports an uncontrollable urge to push. Upon assessment, she is 10 cm dilated and the fetal head is at +2 station. While Cece is pushing, the fetal heart rate drops to 100 bpm and remains there for two consecutive contractions while variability remains moderate. What is the nurse’s priority action?j. Call for immediate cesarean sectionk. Reposition the patientl. Continue to monitor the FHR closely
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