Case study:
Mrs. Elizarde, is a 28 year old G3P2 who was admitted at term at 9:30 PM. She said she had been having
contractions at 8 to 10 minutes interval since 5 PM. They lasted 30 seconds. She also stated that she had
been having “a lot of false labor” and hoped that this was “the real thing”. Her membranes were intact.
Mrs. Elizarde’s temperature, pulse and respirations were normal and her blood pressure is 120/80. The
FHT is 135 bpm and regular. The nurse examine Mrs. Elizarde’s and found that the baby’s head is at +2
station and the cervix is 5cm dilated and 80% effaced. She reported her findings to the doctor and she
ordered Demerol 50 mg with Phenergan 25 mg to be given intravenously when needed.
Questions:
1. Do you think Mrs. Elizarde is in false labor? Give reasons for you answer
2. As Mrs. Elizarde is getting into her bed, her membranes ruptured. What is the first thing that
you would do after this occurs, why?
3. After her membranes ruptured, her contractions began coming every 4 minutes and lasted 45 to
55 seconds. They are moderately strong. Why is it important for Mrs Elizarde to relax during her
contractions? How can you help her to relax?
4. When do you think Mrs. Elizarde should be given medication ordered by the order?
a. What safety measures should be taken at the time medication is given?
b. What aobservations shouls be made after it is given? Why?
c. What observations would you report to the doctor?
5. How would you know that Mrs.Elizarde has entered the transition phase?
6. A vaginal exam revealed that Mrs. Elizarde is complete and +3
a. What should be the nursing intervention at this time?
7. What is ritgen’s manuever?
a. Is it important to do ritgen’s manuever during delivery?
The doctor gave her a pudendal block and did a midline episiotomy. At 11:05 PM, Mrs Elizarde gave
birth to a 8 lbs, 5 oz baby boy in the LOA position. The nurse puts medicine in the baby’s eyes and placed
an identifying bracelet on his right wrist and ankle. A matching bracelet was placed on the mother’s
wrist. The baby was shown to his mother and then taken to the nursery. At 11:30 PM the placenta was
expelled.
8. Why is the medicine put in the baby’s eyes?
9. Why is it important to put identification on the baby in the delivery room?
10. What care should Mrs. Elizarde receive before she is transferred to the recovery room, why?