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  • Abruption Placentae with Preterm Labor and Delivery Unfolding Reasoning Case Study

Abruption Placentae with Preterm Labor and Delivery Unfolding Reasoning Case Study

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geneRAL

APPEARANCE:
5’ 4= (162.5 cm) tall and weighs 165 pounds (75 kg), including 25 pounds (11.4 kg) she
gained during this pregnancy. Appears uncomfortable, groaning and holding abdomen
RESP:
Breath sounds clear with equal aeration bilaterally, labored respiratory effort
CARDIAC:
Pale, cool/dry, no edema, heart sounds regular with no abnormal beats, equal with palpation
at radial/pedal/post-tibial landmarks
NEURO:
Alert and oriented to person, place, time, and situation (x4)
FETAL Monitoring:
 
Electronic Fetal
Monitoring:
Fetal heart rate 150, minimum variability trending towards absent variability around the
baseline, late decelerations, no accelerations noted. Contractions are frequent: every 1-2
minutes; uterus is board-like upon palpation
PRIORITY Setting: Which Orders Do You Implement First and Why?
Care Provider Orders:
Order of Priority:
Rationale:
ď‚· Oxygen -10 liters/minute vis
non-rebreather
ď‚· Continuous fetal monitoring
ď‚· Insert urinary catheter with
urometer for hourly I and O
ď‚· Lactated Ringers (LR) IV 1000
mL bolus
ď‚· Type and screen for <maternal
pack= that includes 6 units
PRBCs, 4 units FFP, 1 apheresis
pack of platelets. This ratio can be
repeated as needed based on labs
(Drawn per policy, usually every
4 hours for 24).
 
 
 
Lab Results:
 
What lab results are RELEVANT and must be recognized as clinically significant by the nurse?
RELEVANT Lab(s):
Clinical Significance:
TREND:
Improve/Worsening/Stable:
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
What lab results are RELEVANT and must be recognized as clinically significant by the nurse?
RELEVANT Lab(s):
Clinical Significance:
TREND:
Improve/Worsening/Stable:
 
 
 
 
 
 
 
 
 
Complete Blood Count (CBC:) (Pregnancy Values)
Current:
High/Low/WNL?
Previous:
WBC (5,000 – 15,000 mm 3)
15.1
 
14.8
Hgb (11.5-14 g/dL)
9.5
 
11.2
Platelets (150-350 x103/µl)
101
 
122
Coags:
Current:
High/Low/WNL?
PT/INR (0.9–1.1 nmol/L):
1.7
 
PTT (29-35 seconds):
45
 
Fibrinogen (<80 mg/dL):
44
 
Kleihauer-Betke test (Positive if
>0.01 mL of fetal blood in the
maternal circulation

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  • Uploaded

    23 February 2024

  • Updated

    03 April 2025

  • Category

    Nursing

  • Item Type

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    Abruption Placentae with Preterm Labor and Delivery Unfolding Reasoning Case Study

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