Sarah Year Unscheduled Explained for Students (Easy Guide)
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Original Question
Sarah (she/her) is a 37 year-old G6P5 who had an unscheduled repeat C-section today at 0900, at 36 3/7 weeks, and gave birth to a baby boy named Walker, who weighed 6# 2 ounces. Her section was at 8 AM, and you are the night shift nurse, taking over care at 7 PM. Sarah’s blood type is A+, she was GBS-, Rubella Immune, Hep -. She is allergic to penicillin. Past medical history is significant for preeclampsia in her first and second pregnancies. Fundus is firm, one finger-breadth below umbilicus, bleeding is moderate, urine output via Foley catheter is 30cc/hour and dark yellow. She received a Duramorph spinal and ketorolac in the OR. Vital signs are 148/90, RR 24, HR 97, oral temp 98.4 F. Currently rating her pain at 3/10, denies nausea. Is drinking ample water and her IV is running at 125/hour. She has eaten some crackers and tolerated them well. Her CBC showed Hgb 9.8, HCT 29.4, WBC 13.9, PLT 110. Walker had APGARs of 6/9, and did have about 30-45 seconds of PPV for low tone and poor color. He is breastfeeding, but having some difficulty latching on. He latched on well once or twice today, but mostly has been spitting up a lot and also very sleepy. Questions to answer: 1. What further information do you need before you begin to take care of Sarah? 2. What are your priorities for caring for Sarah tonight? 3. What are Walker’s risk factors that might contribute to poor breastfeeding? 4. What is your plan for breastfeeding for the night?
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