Concept map nursing

History of Present Problem:

Jennifer Lopez is a 25-year-old female patient G1P0 who is currently 39 3/7 weeks gestation. She is admitted to the hospital to be induced for being post-date. She is positive for Group Beta streptococcus and receiving IV antibiotics per protocol. She is 65 inches (162.5 cm). Her pre-pregnancy weight was 115 pounds (52.3 kg). She gained 18 pounds (6.8 kg) during this pregnancy. She just had spontaneous rupture of membranes with a moderate amount of thick meconium fluid at 9 pm. The nurse performed a vaginal check, and her cervix is dilated to 4 cm, 8 percent effaced and -1 station. Pitocin is infusing at 8 mU/minute intravenously.

Personal/Social History:

Jennifer lives with a roommate and is no longer involved with the father of her baby. Her family support is limited to her older brother, Sal. She smokes one pack of cigarettes a day and has not had a job for over a year and states money is tight. She admits to not eating very healthy during the pregnancy because it is easier to grab hamburger and coke than cook. She missed a few of her prenatal visits due to transportation issues and did not attend any prenatal classes. Her sister is present as her support person during labor and delivery.

Over the past hour, fetal heart tones (FHT) have remained at 140 with

Minimal variability and no accelerations. She has had three more variable decelerations lasting 30-40 seconds. You position Jennifer on her left side, and she receives an IV bolus of 1000 mL LR and O2 is applied via non-rebreather mask at 10 liters. You are in the room trying to help her breathe through her contractions when she has a prolonged late deceleration lasting three minutes with FHTs in the 70s before returning to 120 bpm.

Medical Management

Consent for C-section

Stop Pitocin

Terbutaline 0.25 mg subcutaneous x1

dose

0.9% NS 1000 mL IV bolus

Foley indwelling catheter

O2 at 10 L via mask