Pregnancy Case Studies: Assessments and Interventions

Exc. 5 1.Center A woman, 28 years old,since primigravida, 28 weeks pregnant, came to the Community Health with complaints yesterday that she had not felt the movement of her fetus. The client feels anxious aboutrate his20x/minute, condition. BPtemperature examination37.50C. resultsThe 130/70 mmHg, pulse rate 84x/minute, respiratory nurse carries outinan examination to confirm the condition of the fetus.What is the appropriate examination this case? A. Ultrasound B. DJJ C. TTV D. Oxygen saturation E. Blood gas analysis Answer Key: B. DJJ Discussion:Examination toDJJconfirm the that condition of theis alive. fetus The by listening to DJJfor(fetal heartbeat). The sound of indicates the baby normal range DJJ is between 120-140x/minute. A decrease/increase in FHR indicates danger to the fetus/fetal stress which can also be felt by the mother by decreasing fetal movement. 2.Polyclinic A woman,for28a routine years old, G1P0A0,check-up. 36 weeks pregnant, came with her120/70 husband to thepulse KIA pregnancy BP examination results mmHg, rate 80x/minute, respiratory rate 20x/minute, temperature 37.2oC, Leopoldis3 the found a soft mass, less round and less bouncy in the suprapubic area, single fetus.What correct interpretation of the results of the mother's pregnancy examination? A. The head below has not entered the pap B. The lowest position is the buttocks C. Right back D. Transverse position of the fetus E. Normal presentation Answer Key: B. The lowest position is the buttocks. Discussion:The third Leopold maneuver involves examining theof suprapubic areaand to determine what part of the fetus is positioned below (in front the birth canal) whether thatinpart entered area, the upper inlet.is the If thefetus' massbuttocks. is soft, less round and less bouncy the has suprapubic then pelvic that part 3.examination. A woman, 30BPyears old, G1P0A0, 32 120/70 weeks pregnant, comes to84x/minute, the MCH clinic for rate examination results mmHg, pulse rate respiratory 20x/minute, temperature 37.2oC, Leopold found a soft, less round and less elastic massThe in the fundus. There are small parts of the fetus on the left side of the mother's stomach. head hastoentered location listen totheDJJupper in thispelvic case?outlet. Next, the nurse performs Where is the correct a DJJ examination. A. Lower right quadrant B. Upper right quadrant C. Lower left quadrant D. Upper left quadrant E. Around the center Answer Key: A. Lower right quadrant Discussion:The correct location to listen tosothe fetal heartbeat ispunxtum in the direction of theis in fetus's back, in the direction of the heart that the maximum in this case the right quadrant, at the bottom because the fetus has entered the PAP. 4.Community A woman,Health 32 yearsCenter old, G2P1A0, 37 weeks pregnant, came withofhershortness husbandoftobreath, the for an ANC examination, complaining especially sleeping on her back,Blood afterpressure activities.examination Examinationresults results: Weight increased by 10 kg from before pregnancy. were 110/70 mmHg, pulse rate 80x/minute, respiratory 24x/minute.is the Thecorrect nurse explains the physiology the disturbance experienced by therate mother.What explanation in this case?of A. Normal condition because the fetus uses a lot of oxygen B. The fundus of the mother's uterus pushes the diaphragm upwards C. Reaction to pregnancy and its hormones D. There may be pregnancy complications E. Mother is too tired because of her work Answer Key: B. The fundus of the mother's uterus pushes the diaphragm upwards Discussion:Physiological conditions resulting from pregnancy can cause discomfort to to pregnant women. In the third trimester, the mother will feel a little short of breath due the enlargement of thechest uterus due to the enlargement of the fetusinpushing diaphragm upwards, expansion is restricted, which results a feelingtheof tightness. 5.examination A woman, 38results years100/70 old, P2A0, normal postpartum 1.5 hours ago, in the delivery room. BP mmHg, pulse rate 98x/minute, respiratory rate 22x/minute, temperature 37oC, TFUatat500central level,action uterine are inhard, bleeding is measured ml.What doescontractions the nurse take thisacral case?is cold, A. Fundus massage B. Notify the doctor C. Record patient data D. Ergometrine injection E. Trendelenburg position Answer Key: E. Trendelenburg Position Discussion:In thishypovolemic case there was postnamely partuma decrease bleeding inof BP 500(100/70mmHg) ml with initial signs that lead to a risk of shock, and cold acral sothe thatbrain it needs toheart. be givenTrendelenburg position which aims toreplace increaselostblood flow to and The next action to treat hypovolemia is to fluids (install an IV) and look for the cause of bleeding.Hard contractions are a sign of good uterine muscle suspicion of bleeding occurs due to retained tissue, a tear in the birth canal or a tone, bloodsoclotting disorder.