You are working on a Labor and Delivery Unit. It is 11:30 pm. There are three clients already admitted in labor. There are two RN's and one patient care tech working.
- Client 1, Sue, is a 26-year-old single white female pregnant with her first child at 41 weeks gestation. She was admitted three hours ago at 100% effacement and 3 cm dilated. The baby is at -2 station. Her membranes are intact.
- Client 2, Jane is a 39 year old married Haitian American multigravida who was admitted yesterday morning with preterm, premature rupture of membranes at 36 weeks gestation. She is being induced with Pitocin and her vaginal exam was done at 11:15pm. She had progressed to 6 cm, 100% effaced and the baby is at +2 station. Her vital signs are temp 100.2, pulse 88, respirations 24 and BP 130/88.
- Client 3, Molly, is a 17 year old single white female, primigravada who was admitted two hours ago after being in labor at home all day. Two hours ago a vaginal exam revealed that she was 6 cm, 100% effaced and the baby was at +1 station. Her membranes are intact.
- Sue calls and asks for an Epidural
- Jane calls and wants to come off the fetal monitor and walk around
- Molly wants to get up and states she needs to go to use the bathroom to move her bowels.
- There is also a call from admitting that a new client has just arrived and needs to be brought to the labor unit. The labor unit is expected to send someone to transport her. The clerk at the admission desk said that she seems to be in very active labor and this is her 4th child.
Questions:
- How would you manage care between the 2 RN's and the patient care tech. Which clients need the most immediate attention and why? Discuss how you as one of the RN's would organize care for these clients.