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Miranda Johnson is a 32-year-old G3P2 at 39 weeks of gestation who was admitted to labor and delivery at 0330 in active labor. Their last pregnancy was 10 years ago. A sterile vaginal examination (SVE) was performed on admission and the client was 2 cm dilated, 80% effaced, and -1 station. They reported a small amount of blood-tinged vaginal discharge, but membranes were intact. Contractions were every 4 to 5 minutes and lasted approximately 40 to 50 seconds with a reassuring fetal heart rate (FHR) pattern. They reported pain of 4 on a scale of 0 to 10 on admission, with most of the pain in their back and vaginal area, and that they will likely want an epidural like in their prior births. The client’s current weight is 113.6 kg (250 lb) and they have mild scoliosis. They reported having an allergy to penicillin. The client’s significant other is in the room. At 0600, the client had a spontaneous rupture of membranes (SROM) and fluid was clear. SVE shows the client is currently 4 cm dilated, 90% effaced, and 0 station. Contractions are every 3 to 4 minutes, lasting 40-50 seconds with a reassuring FHR pattern. Pain is an
SCIENCE
HEALTH SCIENCE
NURSING

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