Sally Brown
Patient Info
G6P5
40.2 weeks
Rub-I, TdAP Flu UTD
38 y.o. married
Medical History
EI Asthma
Last Labor: 3 hrs
Vital Signs
SROM (in car)
RR: 20
HR: 80 BPM
Temp: 98.9 F
BP: 128/78
Exam Results
+1
100% Effaced
SVE: 9 cm
Clear Fluid
Nursing Diagnoses
Risk for hemorrhage r/t advanced maternal age, multiparity.
Risk for exacerbation of asthma r/t laboring.
Risk for acute pain r/t uterine contractions and delivery
Concerns
Antibiotics ordered? #
Precipitous labor and delivery
RhoGAM administered @ 28 weeks? #
FHT Monitoring
130 BPM
Moderate variability
GBS+
No decelerations
UC: 3-5 min; firm
Blood: A-
Perineal Tearing; hemorrhage
Orders
Admit
Start IV
Put on Monitor #
Sterile Vaginal Exam #
Update Provider after assessment
Interventions
Obtain and monitor vital signs.
Monitor/assess respiratory status throughout labor, continuous pulse ox.
Continue to use asthma medication as needed
If hemorrhage occurs use prostaglandin E1 or E2, continue to monitor respiratory status.
Avoid use of carboprost, ergonovine, methylergonovine which can cause bronchospasm
Monitor discharge throughout labor, looking for signs of painless bright red bleeding.
Prepare for possible C-section
Type and cross for blood products
Supplemental oxygen ready.
Assess and Manage Pain
Non-pharmacological pain management: breathing exercises, exercises/movement, water therapy, massage
Pharmacological pain management such as Fentanyl. Avoid morphine and meperidine (histamine releasing and may exacerbate asthma)