Patient Samantha is a 42 y/o married, gravida 5 para 3. She is 4’10” tall, and weighs 200 lbs.

She works as an
administrative aide in a government institution, and her husband is a Police Officer. Their eldest child is 10 y/o, her
2nd child is 7 y/o and the youngest is 4 y/o. she had an abortion 2 yrs prior to her pregnancy. Her LMP was on May
30, 2020. In her 2nd month of pregnancy, she had fever and experienced difficulty of urination. Her obstetrician
ordered cephalexin 500mg TID, biogesic 500mg q6hrs or PRN for fever. she was also advised to increase her oral
fluid intake.

When she was on her 2nd trimester, she experienced mild uterine contractions and her obstetrician ordered
Isoxsuprine Dinitrate(Duvadilan) 10mg TID. She was also confined in the hospital for 3 days because of fever due
to acute respiratory Infection when she was 7 mos pregnant. She was was only treated symptomatically. She was
discharged from the hospital after 3 days.

She was rushed at the ER this morning at 6:30am, due to lumbo sacral pain and she stated that she had been having
contractions at 7 to 10 minute intervals since 1am. She also stated that she had been having ‘a lot of false labor’ and
hoped that this was ‘the real thing’. Her membranes were intact. Patient Samantha’s temperature, pulse and
respiration are normal and her blood pressure was 130/90. The fetal heart tone obtained was 134 beats /min, and is
regular. The nurse examined patient Samantha and found that the baby’s head was at +1 station, and the cervix was
4cm. dilated and 80percent effaced. She reported her findings to the doctor and he ordered Demerol 50 mg with
Phenergan 25mg to be given intravenously when needed.

After 4 hours, of monitoring the patient’s progress of labor, the nurse performed internal exam and found out that
the patient is 6m dilated. Her v/s remained normal at 36.9, 70, 20,130/90 with an FHT of 136 beats/ min. At 2pm she
was again examined and her cervical dilatation remained at 6cm. Here V/s remains to be at a normal range except
for her BP which became slightly elevated at 150/90 and the fetal heart tone became irregular at 166, 149, 160, 155,
168 beats/ min monitoring record from 10 am to 2pm.

1. Do you think patient Samantha is in true labor? Give reasons for your answer
-Yes, because she stated that she was rush to the ER due to lumbo sacral pain and she stated that she
had been having contractions at 7-to-10-minute intervals and the nurse examine patient Samantha and
found that the baby’s head was at +1 station, and the cervix was 4cm dilated which means she is now in
 active phase stage of labor and 80percent effaced which means thinning effacement of cervix which will
progress to the final outcome the final dilatation.

2. As patient Samantha is being transported to her room at around 8am her membranes
ruptured with clear, odorless fluid. What is the first thing that you would do after this
occurs? why?
- The first thing to do is rush Samantha to the delivery room as being stated her membranes has
already ruptured with clear and odorless fluid which means no signs abnormalities for her and
to be monitored.
3. Do you think Patient Samantha will be able to deliver her baby normally? Explain further
-No because her blood pressure suddenly spikes and her FHT is irregular which means she can’t
undergo via normal delivery because it might lead to several life-threatening complications
during her delivery. Complications that could arise for the mother during a delivery include:
bleeding in the brain, or hemorrhagic stroke seizures. Which means she will now undergo C-
section, or Caesarean section because her cervical dilatation progress has stopped that is also a
factor that she cannot give birth to normal delivery.

4. With the given data in the scenario, fill out the partograph for Patient Samantha.