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1315 The nurse returns call to client and gathers the following assessment data: The client is at 39 5/7 weeks’ gestation based on her last menstrual period The client saw an obstetrician in the office yesterday, and the doctor told her she was “getting close.” Her cervical examination from the day prior and per the medical record was 3 cm, 90% effaced, 0 station (vertex). The client began having contractions an hour ago, and they were 5 minutes apart. The client took a walk around her block, and the contractions are now 3-5 minutes apart. The client describes her contraction pain as “the worst period cramps of my life” and rates them a 10/10 on a scale of 0-10. The client describes pain in her back and states, “I hope I don’t have back labor like my friend did!” The client said the pain is mainly in the lower back and is a 5/10 on a scale of 0-10. 1320 The nurse instructs the client to go to the Labor and Delivery triage area for a labor check and ends the call with the client. 1400 Admission to triage Client presents from home for a labor check. The client is a 32-year-old Gravida 1 Para 0 at 39 5/7 weeks’ gestation (based on her last menstrual period). Client states that she was “seen in the office the day before and her last cervical examination was 3 cm dilated and 90% effaced, and the baby’s head is in the birth canal.” She is in visible pain and breathing through her contractions. 1420 Admission to Labor and Delivery Client is admitted to labor and delivery in active labor with orders from the healthcare provider. Cervical examination in triage was 5 cm/100% effaced/+1 station (vertex), intact membranes, fetal heart rate within normal limits, contractions every 3 minutes and moderate to strong in intensity (via palpation), and client requests an epidural for a pain of 10/10. Client moved from the stretcher to the labor bed. An 18-gauge intravenous (IV) catheter inserted, and a complete blood count (CBC) and type and screen obtained and sent to lab, Lactated Ringer (LR) solution hung and open to bolus, and Anesthesia department notified that client requests epidural anesthesia. Nurse reviews orders and client’s prenatal history. The nurse is determining the plan of care for the client. Choose the most likely options for the information missing from the statement(s) by selecting from the lists of options provided. The nurse prepares the client for epidural anesthesia by initiating ———-Select response and ——Select response but would be concerned about the client’s ———Select response Select response Call to anesthesia Straight catheter IPC device NPO status Select response Indwelling catheter IV bolus of LR LR at 125 mL/hour GBS culture Select response AB- blood type Rubella status equivocal Platelet count 150 billion/L Hematocrit 35%

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