Cervical dilation and the fetus station

Maternity Case 4: Brenda Patton (Complex)

Guided Reflection Questions

Scenario Analysis Questions1
EBP Based on the initial assessment of Brenda Patton, what findings did you find concerning?

Initially what was concerning was the fact that she is sweating and had a fever of 102 degrees F. This made me think there was an infection or something going on inside her body. The other thing that was concerning to me was that the babies heart rate was 180 when the normal heart rate range is 110-160 so that made me feel as if the baby was under some sort of distress.

This is a 18 year old G1PO at 36 2/7 weeks gestation. The patient says that her water broke earlier this morning. AmniSure was positive and upon a vaginal exam it determined that she has 90% effacement of her cervix, cervical dilation at 4 cm and the fetus is at -1 station. Vital signs were heart rate 96, blood pressure 128/76, respirations 21, SpO2 97% and a temperature of 39.2. The fetal hear rate was 180 with occasional accelerations. She is sweaty and is having contractions that are moderate intensity and are about 4 and a half minutes apart. She was swabbed for GBS and those results are pending. She was also given Cefazolin 2g iv and 1000mg of acetaminophen as well. Her boyfriend is present and knowns and understands what is going on. The NICU has also been notified of the possible risk.

S/QI Based on your experience with Brenda Patton’s case, reflect on possible nursing actions for enhanced safety and quality improvement.

The knowledge that I will take with me is that I need to be supportive for these patients and do whatever I can to calm them down as needed. It is super important to provide these patients with support. I will also take the fact that asking too many questions can tire out these patients so I need to understand how to do my assessments more efficiently.