Davao Doctors College, Inc.

College of Allied Health Sciences

Nursing Program

NRG203: CARE OF MOTHER, CHILD, AND ADOLESCENT

(WELL CLIENTS), INTRAPARTUM PERIOD

[STUDENT’S COPY]
Getting to Know the Course Instructor
Hello! I am Mae Gonzales , your
clinical instructor for the week, and I’d like to welcome
you to your first simulation with standardized patient
module for NRG203:

CARE OF MOTHER, CHILD AND ADOLESCENT (WELL CLIENTS)

I, on behalf of the Nursing Program, am looking forward
to guiding you in learning this course well and in
developing your critical thinking and communication skills
in the process.

Please read the RLE Practice Guidelines for Simulation with Standardized Patient before
proceeding to the next part of this module.

Once you are done acquainting yourself with the instructor and the course itself, please proceed
to SP Module: Assessment and care of a woman in Intrapartum stage.

SCENARIO OVERVIEW
Case: Normal Delivery in 24 -year-old Primi-Para in Active Labor.

Summary of Case: A 24 -year-old, married woman named Ana Perez, admitted at Davao
Doctors Hospital, Inc. L & D and monitor placed in active labor, accompanied by her husband
and mother. She was brought to the ED due to GI distress and abdominal pain. Assessment
indicates that she is on active labor; primipara presents at 39 weeks estimated gestational age
to Labor and Delivery in early labor with the onset of contractions approximately one hour ago.
Her records indicate she is carrying a singleton pregnancy in vertex presentation. Her past
medical history is uncomplicated. She develops hives at 14 weeks AOG. Specific IgE test came
in negative for food allergens (Class 0: Absence of IgE). She is taking Levocitirizine 5mg 1 tab
OD at HS until delivery and prenatal vitamins that were ordered by her OB. Her prenatal labs
are negative and her pregnancy has been uncomplicated.

SP MODULE 3: CARE OF WOMAN IN INTRAPARTUM STAGE (WELL CLIENT)

Davao Doctors College, Inc.
College of Allied Health Sciences
Nursing Program

031984 PEREZ, ANA October 1, 1999 457 Dr. Sy NONE

NTNEKNOWNKKNOWNALLERGIES

October 12, 2023 @ 7:00AM

-24 yrs.old Primi-Para on her 39th

Please admit under the service of Dr. Sy
weeks AOG -VS q hour
- Hook EFM monitoring; Monitor labor in progress
(-) vomiting - Please monitor FHT
- I&O q shift
(+) GI distress
- DAT
(+) Abdominal Pain - IVF: D5LR 1L @ 120cc/hr.
Labs:
RAT
T- 36.3 Urinalysis
BP- 120/80 CBC
Chest X-ray
RR- 20 Blood Typing
PR- 81
Meds:
SPO2-98%
-Start Oxytocin Drip
- Give PLR500cc fast drip while on left side lying
TT- 2 doses given April 15, 2023 1st dose position
-Hold Levocitirizine tab temporarily
September 18, 2023 2nd dose Watch out for any unusualities,
Please Refer and facilitate lab works. Dr. Ryan Sy

SP MODULE 3: CARE OF WOMAN IN INTRAPARTUM STAGE (WELL CLIENT)

Davao Doctors College, Inc.
College of Allied Health Sciences
Nursing Program

031984 PEREZ, ANA October 1, 1999 457 Dr. So NONE

NTNEKNOWNKKNOWNALLERGIES

October 12, 2023 @ 8:00AM

Labor Admission Orders:
Medications:
- Pt. on active labor 1. Enoxaparin 40 mg subcutaneous every 24
hrs;
2. Nalbuphine 5mg IV every 2 hrs. PRN
moderate pain or Acetaminophen 650mg
PO every 4 hours PRN
3. Aluminum and Magnesium Hydroxide 30 ml
PO every 2 hours PRN for indigestion,
4. 4.Metoclopromide 10mg IV every 4 hours
PRN for nausea and vomiting
5. Pitocin 6 mUnits/min; decrease dose to 4mUnits
when contraction progressed to 5-6cm dilation

Dr. Ian So

SP MODULE 3: CARE OF WOMAN IN INTRAPARTUM STAGE (WELL CLIENT)

Davao Doctors College, Inc.
College of Allied Health Sciences
Nursing Program

Patient Name: PEREZ, ANA

Hospital Number: 031984

No definite abnormal pulmonary densities seen. Heart is not enlarged. Both hemi diaphragms and
costophrenic sulci are intact. Rest of the included structures is unremarkable.
Impression:
Normal Chest Findings

SP MODULE 3: CARE OF WOMAN IN INTRAPARTUM STAGE (WELL CLIENT)

Davao Doctors College, Inc.
College of Allied Health Sciences
Nursing Program

Name: PEREZ, ANA Lab no: 210280427

PID: 3393045 Location: Emergency Room - IPD

Age: 24 years old Sex: Female Physician: SILVER LEE, MD

Date Received: 10-12-2023, 07:20 AM Date Released: 10-12-2023 08:15 AM

-----------------------------------------------------------------------------------------------

TEST RESULT REFERENCE RANGE

-----------------------------------------------------------------------------------------------

HEMATOLOGY

Blood Type (ABO + Rh)

Blood Type O

Blood Type Rh POSITIVE

*BLOOD TYPING PERFORMED BY: ED FRANCIS CAPULONG, RMT*SAMPLE EXTRACTED BY: PRINCESS TONZO, RN

CBC + PLT

Result Normal Range

Hemoglobin 121.0 g/L 115 - 155

Hematocrit 0.36 0.36 - 0.48

RBC Count 4.56 x10^6/uL 4.20 - 6.10

WBC Count 8.18 x10^3/uL 5.0 - 10.0

Neutrophil 63 % 55 - 75

Lymphocytes 26 % 20 - 35

Monocytes 10% 2 - 10

Platelet Count 268 x10^3/uL 150 - 400

*** This is electronically generated report. No signature is required. ***

SP MODULE 3: CARE OF WOMAN IN INTRAPARTUM STAGE (WELL CLIENT)

Davao Doctors College, Inc.
College of Allied Health Sciences
Nursing Program

PEREZ, ANA

10/01/1999 10/01/2023 6:00 AM

10/01/2023 6:00 AM

09/30/2023

Scenario Objectives
1. Establish rapport with the patient.
2. Utilize principles and care practices related to normal labor and delivery.
3. Accurately assess the laboring mother and estimate labor progress based on client
responses.
4. Recognize normal fetal heart rate pattern.

SP MODULE 3: CARE OF WOMAN IN INTRAPARTUM STAGE (WELL CLIENT)

Davao Doctors College, Inc.
College of Allied Health Sciences
Nursing Program

5. Provide safe care to laboring patients, prioritizing and implementing interventions for
mother
and fetus.
5. Communicate relevant patient information to team using SBAR tool.
6. Implement critical thinking and clinical decision-making skills necessary to interpret
data
7. Implement appropriate nursing interventions at this point in the labor process.
8. Integrate understanding of multiple dimensions of patient-family centered care.

Point to Review:
1. Interacting with an admitted Patient (7-3 shift)
2. Performing nursing tasks done upon encountering a patient after receiving handover
3. Administration of medications
4. Health education for the new mother.
5. Ending the shift

Note: Please be informed that there will be a pre-briefing session prior to the start of
the simulation. After all simulations, a debriefing session will be conducted together
with the CI and SP

References:
Berman, A., Snyder, S., & Frandsen, G. (2016). Kozier & Erb’s fundamentals of nursing:
Concepts, process, and practice (10th ed.). Pearson Education, Inc.
Silbert-Flagg,J. & Pillitteri, A. (2018). Maternal & Child Health Nursing, Care of the
childbearing & Childrearing Family, 8th Edition. Wolter Kluwer Health
Doenges, M., Moorhouse, M. & Murr, Alice (2016). Nurse’s Pocket Guide Diagnoses,
Prioritized Interventions, and Rationales(15th Edition). F.A. Davis Company
Quigley, B., Palm, M.L., & Bickley, L. (2012). Bates’ nursing guide to physical
examination and history taking (1st ed.). Wolters Kluwer Health

SP MODULE 3: CARE OF WOMAN IN INTRAPARTUM STAGE (WELL CLIENT)