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Maternal Newborn Nursing

What Should the Nurse Do?

Maternal Newborn NursingWhat Should the Nurse Do?

What Should the Nurse Do?

Siobhan, a 28-year-old pregnant female at 38 weeks’ gestation, presents to the maternity clinic for a routine checkup. She is a gravida 2, para 1, having delivered a healthy baby girl vaginally 3 years ago. Siobhan is accompanied by her partner and expresses excitement and anxiety about the impending birth. Siobhan reports experiencing intermittent lower back pain and a sense of pelvic pressure over the past 15 hours. She also mentions a noticeable increase in vaginal discharge. She denies any vaginal bleeding, ruptured membranes, or severe abdominal pain. Her partner notes a change in fetal movement, with the baby seeming more active than usual. Siobhan has a history of gestational diabetes, well managed through diet and exercise. She has had regular prenatal checkups throughout this pregnancy, and her blood pressure has remained within the normal range. Fetal ultrasound scans have indicated a healthy, appropriately sized fetus. Siobhan’s medical history is otherwise unremarkable.

At the time of admission her vital signs were as follows: blood pressure: 120/78 mm Hg, heart rate: 88 bpm, respiratory rate: 18 breaths per minute, temperature: 98.6° F (37° C), and fetal heart rate: 140 bpm, regular rhythm.

1 .
What key signs and symptoms in Siobhan’s presentation might indicate the initiation of labor, and how would you distinguish them from normal third trimester discomfort?
2 .
Based on an analysis of Siobhan’s case, what immediate actions should a nurse take to address her concerns, ensure fetal well-being, and facilitate an effective labor assessment?
Carmen, a 32-year-old pregnant female at 39 weeks’ gestation, arrives at the maternity clinic for a scheduled checkup. She is accompanied by her husband, Carlos, who has been her primary support throughout the pregnancy. Carmen is a gravida 2, para 1, with a history of a previous cesarean section. The couple is eagerly anticipating the birth of their second child via VBAC (vaginal birth after cesarean). Carmen reports intermittent contractions and a sense of pressure in her lower abdomen over the past 24 hours. She denies any vaginal bleeding, rupture of membranes, or severe abdominal pain. Carlos mentions that Carmen has been experiencing increased anxiety as her due date approaches, and they express concerns about the upcoming labor, especially considering the previous cesarean section. Carmen has a history of gestational diabetes, which has been well managed through diet and regular monitoring. Her blood pressure has remained within the normal range throughout the pregnancy, and fetal ultrasound scans have shown a healthy, appropriately sized fetus. Carmen’s previous cesarean section was due to breech presentation in her first pregnancy. Her vital signs are as follows: blood pressure: 118/76 mm Hg, heart rate: 92 bpm, respiratory rate: 18 breaths per minute, temperature: 98.7° F (37.1° C), and fetal heart rate: 145 bpm, regular rhythm.
3 .
What nonpharmacologic solutions can the nurse suggest to address Carmen’s anxiety and support needs during the prenatal visit, and how might these solutions involve Carlos in the process?
4 .
As the nurse, what specific actions would you take during the visit to address Carmen’s anxiety, enhance her understanding of the upcoming labor, and ensure both she and Carlos feel adequately supported?
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