Problem:
As the nurse, you are evaluating Emma, who is a G2 P1001, in triage in the labor and delivery unit. She arrived in the triage unit at 3 a.m. at 38 weeks 5 days gestation with complaints of uterine contractions that were 10 minutes apart for the last several hours. Emma is accompanied by her boyfriend and appears comfortable but expresses concern and states she worries that her 13-month-old son will be upset when he wakes and she is not there.
A physical examination of Emma reveals the cervix is 2 cm dilated / 40% effaced / - 1 station. She states she had a normal spontaneous vaginal delivery (NSVD) after a 26-hour labor for her son.
Prenatal lab results:
?Blood type O-
RPR NR (non-reactive)
Hepatitis negative
GBS +
Vital signs: Blood Pressure 110/60; pulse 84 bpm; respirations 18; temperature 98.6 F (37 C).
Q1. What additional assessment data will you need to gather?
Q2. After reviewing her labs, what interventions can you expect to implement and why?
Q3. The vaginal exam is recorded as 2/40%/-1. Explain what information each number provides.
Q4. Based on Emma's exam, how far along in the labor process is she? Include the rationale for your response.