Passage / Scenario

Nurses' Notes 0830: The client is a gravida 2 para 1 at 30 weeks of gestation. Reports low back pain and abdominal cramping for the past two days. History includes cesarean birth for breech presentation. Reports smoking half a pack of cigarettes per day. BMI is greater than 30. The client is grimacing and has a positive report of fetal movement. External electronic fetal monitoring applied, showing fetal heart rate of 148/min. The abdomen is soft and nontender to palpation. 0845: Uterine contractions every 2├óÔé¼ÔÇ£3 minutes, moderate in strength. Sterile vaginal examination reveals cervix dilated to 2 cm, 80% effaced, and -1 station. Mucous vaginal discharge and a small amount of bright red bleeding noted on the perineal pad. Vital Signs: Temperature: 36.8├é┬░C (98.2├é┬░F), Heart rate: 98/min, Respiratory rate: 18/min, Blood pressure: 112/68 mm Hg, Oxygen saturation: 98% on room air.