MEDICAL COLLEGES OF NORTHERN PHILIPPINES

Alimannao Hills, Peñablanca, Cagayan

Telefax No. (078) 304-1010 Website: www.mcnpisap.com
E-mail Address: adminoffice@isap.edu.ph

COLLEGE OF NURSING

Subject Code : NCM 109 Lec

Subject Title : Care of Mother, Child at Risk or with Problems (Acute and Chronic)
Term : Midterms
Semester : Second School Year : 2019-2020
NAME: ___________________________________ DATE: _______________
YEAR/SECTION: ______________

GENERAL INSTRUCTION:
 Read each scenario carefully and accomplish the tasks given.
 Encode your answer using size 8.5x13 inches, 1 inch margin top, bottom , 0.5 inch left
& right margin & font style Tahoma, font size 11.
 All answers must be submitted until 12 Midnight of May 21, 2020
 Send you answer in our google classroom account or through my messenger or email
account (louisevaliente@yahoo.com)

CASE ANALYSIS

Case 1: Complicated Labor and Delivery (50 points)

A nulliparous client was admitted to the birthing unit 9 hours ago.

Vital signs:
BP: 120/80 mmHg
RR: 21 cpm
PR: 96 bpm
Temp: 36.5 degrees Celsius

Other pertinent assessment:

She progressed from 3 cms and 0 station to 6 cms and +1 station, but has not made any
additional progress for almost 2 hours. FHR is in the normal baseline range with moderate variability.
There are no decelerations, contractions are presently every 3 minutes, 40 seconds duration, and of
strong intensity.

Tasks:

1. Following the vaginal examination, what other assessments will you make at this time? (10
points)
2. During the vaginal examinations, you determine that the small triangular fontanel is toward the
mother’s back on the right side. What is the fetal position? Support your answer. (10 points)
3. The client’s husband asks you why labor has not progressed very much. How will you answer
him? (10 points)
4. What Nursing interventions will be most helpful to this client at this time? Give at least four. (10
points)
5. Should you notify her physician at this time? If so, what information will you give and what
medical interventions do you anticipate? (10 points)

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PACUCOA Level 1 Accredited
Case 2: Complicated Postpartal Stage (50 points)

The client is a 16-year old G1P1 who delivered her infant by CS at 37 weeks AOG following
prolonged rupture of membranes and failure to progress during labor. After 24

Tasks:

1. What factors increase the client’s risk for a postpartal infection? Explain your answer briefly. (10
points)
2. What on-going nursing assessments are necessary to identify an infection? Give all possible
assessment. (10 points)
3. What signs and symptoms are used to diagnose an infection? Explain briefly. (10 points)
4. What is the first step in treating an infection? Support your answer (10 points)
5. What nursing diagnoses are pertinent to a client with a postpartal infection? Give at least four.
(10 points)

Prepared by:

NCM 109-LEC TEAM

Subject Teachers

Checked by:

LOUISE V. CABLING, RN, MAN, LPT

Program Coordinator

REYNALDO M. ADDUCUL, RN, RM, MSN, JD.

Dean, College of Nursing and School of Nursery

Reviewed by:

WINNIE T. CANCEJO, RRT, MPH

Quality Assurance Officer

Approved by:

PRESENITA C. AGUON, Ph.D.

Vice-President for Academic Affairs

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PACUCOA Level 1 Accredited