Question: This Is Your SBAR Report From The Night Nurse: S: Mrs. Thomas Is A 35 Yo MWF (married White Female) G6 P5106 (Gravida 6, Para (now) 5 Term, 1 Preterm, 0 Abortion, 6 Living Children)delivered A 9 Lb. 10 Oz. Baby Boy At 0400 Today After A VAVD (vacuum Assisted Vaginal Delivery). Her Postpartum Checks Have Been Within Normal Limits. She Is Due For Her …

This is your SBAR report from the night nurse:

S: Mrs. Thomas is a 35 yo MWF (married white female) G6 P5106(Gravida 6, Para (now) 5 term, 1 preterm, 0 abortion, 6 livingchildren)delivered a 9 lb. 10 oz. baby boy at 0400 today after aVAVD (vacuum assisted vaginal delivery). Her postpartum checks havebeen within normal limits. She is due for her next check in a fewminutes. Her baby had Apgar scores of 5/9. He is being observed inthe SCN for mild tachypnea and grunting.

B: Mrs. Thomas was admitted last evening in early labor, afterhaving SROM at home. Fetal heart rate on admission was at abaseline of 140. Augmentation of labor was begun with Pitocin IV.She received Nubain 10 mg for pain management with subsequentrequest for an epidural. She pushed for 2 hours at which time theFH dropped to the 80’s with poor recovery, and vacuum delivery wasimplemented successfully. EBL was 475 mL.

A: Last VS were 100/60, P = 80, RR = 18 and temp. 37.5 C. Shedenies pain, except for soreness at perineum. She was given 1Motrin 30 minutes ago with relief noted. She also has an ice pack.Fundus is at U, midline and firm. She has moderate amounts rubralochia. She had a foley in for the epidural, it was removed justprior to delivery with 250 mL output. She has not voided since – ithas been 3 hours.

R: She is due for a post partum check and vital signs. You mightwant to offer to assist her up to the bathroom. Review her labs tosee that everything has been addressed- Hgb 12.0, Hct 35%, Bloodtype O neg, she is Group B strep positive, HIV neg, HBsAg neg.

Answer the following questions:

1. Provide drug card information on Pitocin, Nubain, Motrin.
2. State what the normal amount of blood loss is expected after avaginal delivery.
3. Define postpartum hemorrhage.
4. What is a normal Hgb/Hct for a pregnant woman at full termgestation?
5. List 2 risk factors that may contribute to postpartumhemorrhage in this particular situation, and explain yourreasons.
6. Mrs. Thomas is Group B strep positive – what is the propertreatment for a pregnant woman who tests positive for Group Bstrep?
7. Mrs. Thomas’s blood type is O negative. What is administered towomen who are pregnant and who have given birth who are Rh-negative?
8. Include drug card information on any medications administeredin question # 7 and #8.