Chapter 7, Problem 46R

Compare and contrast external and internal Electronic Fetal Monitoring placement.

A client is scheduled for a contraction stress test on the labor and delivery unit following a nonreactive result on a nonstress test at the OB/GYN office. Nipple stimulation will be used to stimulate contractions. What should the nurse tell the client about the purpose of the test and what will be learned about fetal well-being? How can the nurse prepare the client for the test?

Please disucss the following: Topic: Prenatal Care for Women ·      Why is an obstetrician important for pregnant woman to see? ·      Important nutrients: Folic acid, iron, calcium, and vitamin D ·      Why is vitamin C important in iron absorption? ·      Safe physical activities for pregnant woman? ·      Weight gain in pregnancy?

TELEPHONE TRIAGE Scenario: You are the MOA in a busy family practice. The following calls come in to your office. For each situation, respond in the most appropriate manner. How would you handle each call?  If it is for your physician, do you put the call through? Do you take a message? Can you handle the call yourself? Provide a brief explanation for each example. “Hi, this is the nurse from labour and delivery at the hospital. I have one of your doctor’s patients here, and I believe she is in labour. Could I please speak with the doctor?”

Case Study: A mother expecting her first child miscarried at home on June 22, 2010. The pregnancy was six months along. An ambulance was called at 4:57 a.m. The EMTs helped the mother to the stretcher and then went inside to retrieve the fetus from the bathroom floor. The baby was seen moving its head. The EMTs requested ALS to the scene. The baby was placed inside a small container. The ALS personnel visually assessed the fetus and stated the fetus was “non-viable”. There was never a fetal heart check in the field. Mother and fetus were transported to the hospital arriving at 5:16 a.m. At the hospital, a nurse noticed that the fetus was warm and had a heartbeat. The baby was raced to the special care nursery and placed on a warmer. The staff then proceeded to resuscitate the baby. The baby was dusky and noted to have a heart rate of 30 with respirations of 6-8 at 5:40 a.m., and cardiopulmonary resuscitation was initiated. The oxygen saturation was 2-10%. The baby was intubated at 5:55…

Case Study: A mother expecting her first child miscarried at home on June 22, 2010. The pregnancy was six months along. An ambulance was called at 4:57 a.m. The EMTs helped the mother to the stretcher and then went inside to retrieve the fetus from the bathroom floor. The baby was seen moving its head. The EMTs requested ALS to the scene. The baby was placed inside a small container. The ALS personnel visually assessed the fetus and stated the fetus was “non-viable”. There was never a fetal heart check in the field. Mother and fetus were transported to the hospital arriving at 5:16 a.m. At the hospital, a nurse noticed that the fetus was warm and had a heartbeat. The baby was raced to the special care nursery and placed on a warmer. The staff then proceeded to resuscitate the baby. The baby was dusky and noted to have a heart rate of 30 with respirations of 6-8 at 5:40 a.m., and cardiopulmonary resuscitation was initiated. The oxygen saturation was 2-10%. The baby was intubated at 5:55…

Case Study: A mother expecting her first child miscarried at home on June 22, 2010. The pregnancy was six months along. An ambulance was called at 4:57 a.m. The EMTs helped the mother to the stretcher and then went inside to retrieve the fetus from the bathroom floor. The baby was seen moving its head. The EMTs requested ALS to the scene. The baby was placed inside a small container. The ALS personnel visually assessed the fetus and stated the fetus was “non-viable”. There was never a fetal heart check in the field. Mother and fetus were transported to the hospital arriving at 5:16 a.m. At the hospital, a nurse noticed that the fetus was warm and had a heartbeat. The baby was raced to the special care nursery and placed on a warmer. The staff then proceeded to resuscitate the baby. The baby was dusky and noted to have a heart rate of 30 with respirations of 6-8 at 5:40 a.m., and cardiopulmonary resuscitation was initiated. The oxygen saturation was 2-10%. The baby was intubated at 5:55…

You are caring for a client in active labor.  The client and her partner have expressed their desire for a natural birth and have declined medical interventions such as IV placement and continuous fetal monitoring.  The client did consent to intermittent fetal monitoring.  During the period of fetal monitoring, the RN notes repetitive late deceleration and fetal bradycardia of 90 BPM.  The RN receives orders to initiate an IV Stat, and to prepare the client for an immediate cesarean section.  The client declines to have the IV started and states she wants time to discuss the cesarean with her partner. Identify one ethical principle that directly applies to the client.

You are caring for a client in active labor.  The client and her partner have expressed their desire for a natural birth and have declined medical interventions such as IV placement and continuous fetal monitoring.  The client did consent to intermittent fetal monitoring.  During the period of fetal monitoring, the RN notes repetitive late deceleration and fetal bradycardia of 90 BPM.  The RN receives orders to initiate an IV Stat, and to prepare the client for an immediate cesarean section.  The client declines to have the IV started and states she wants time to discuss the cesarean with her partner. Explain two nursing interventions that would comply with ethical and legal standards when caring for the client.