an 18 year old primigravida presents to labor and delivery

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Part 1: An 18 year old Primigravida presents to Labor And Delivery with what appears to be active labor. Upon questioning, you discover she has received no prenatal care. In obtaining some history while placing her on the fetal monitor you learn she is a smoker, approximately 1 pack per day, occasional marijuana for stress, and denies any support system. The Father of the Baby (FOB) has no knowledge of the pregnancy. No prenatal vitamins – they were too hard to swallow. She has no idea when her LMP was and she relates always being very irregular. * remember LMP is to ask the first day of the Last Menstrual cycle, not when the bleeding stopped*
What other questions are essential for her safe care?
What lab values do you need to obtain?
What exam findings should you obtain at this time?
What education will you provide for her?
She asks you how long this will take to have the baby – what is your best response?

Part 2: The patient is now 3cm/100% effaced /-2 station. What is the plan of care for the safety of this patient and her baby? Fetal heart rate is 160 with moderate variability. Contractions are now mild and 15 minutes in frequency.

1. Magnesium Sulfate is used to stop the contractions, and this has been successful.
2. What is the dose you will start with, what is the maintenance dose>
3. Please indicate what nursing interventions are necessary for use with Magnesium Sulfate?

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