Passage / Scenario

Vital Signs: Heart rate: 88/min, Temperature: 37.1°C (98.8°F), Respiratory rate: 16/min, Blood pressure: 122/78 mm Hg. History and Physical: The client is gravida 2 para 1, with a previous vaginal delivery. She has a history of hypothyroidism and Herpes simplex virus type 2. She is currently undergoing labor induction at 39 weeks and 3 days of gestation. Assessment: The fetal heart rate is 140/min with moderate variability, and mild uterine irritability is noted. The abdomen is soft and nontender upon palpation. Cervical examination reveals dilation of 1 cm, thickness, and no presenting part palpable. An ultrasound shows a footling breech presentation. There are clusters of lesions noted on the vaginal introitus and labia majora. Laboratory Results: WBC count: 9,500/mm³ (Normal: 5,000 to 15,000/mm³), Hgb: 10.5 mg/dL (Normal: greater than 11 mg/dL), Hct: 31% (Normal: greater than 33%), Platelets: 225,000/mm³ (Normal: 150,000 to 400,000/mm³), Blood Type/Rh: O+. Provider Prescriptions: Levothyroxine 100 mcg PO once daily in PM, Acetaminophen 325 mg PO every 6 hr PRN, Dinoprostone 10 mg intravaginally x one dose now, Terbutaline 2.5 mcg/min intravenous per provider's instructions.