1) The client tells you that no one monitored her baby while in…

1) The client tells you that no one monitored her baby while in pre-op. She says they used a doppler to listen to the fetal heart rate for about 30 seconds. She would like you to get a NST or an ultrasound. Explain your next steps thoroughly. 

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2) The client desires to be in-patient for 48 hours after the cerclage due to anxiety and fear of complications. Are these reasons indications for in-patient admission? What is the typical recovery protocol for the procedure? How will you address your client’s request? 

Scenario: 

This is Sarah Cade she is a 30-year-old, white female. She is a patient of Dr. Milligan she has received her COVID-19 vaccine she has no known allergies she is a G3 P0 201 she is 14 weeks and four days today and she is in today to have a cerclage. her medical history includes the incompetent cervix in pregnancy, chronic hypertension, obesity. Her surgical history includes a tooth extraction, a cervical cerclage several years ago and a caesarean section. she is not a current smoker or former smoker she doesn’t use any tobacco products she is a social consumer of alcohol but not when she’s pregnant she has a family history of a paternal grandmother with cancer a father with hypertension and a maternal grandmother with osteoporosis. her obstetrical history includes a delivery in 2018 of a 21 week five day old baby that resulted in a neonatal death due to chorioamnionitis she also had a 36 week and 6th day caesarean section in 2019 for a baby girl her medication orders include cefazolin in dextrose IV piggyback solution 2 grams IV once, Ibuprofen tablet 600 milligrams PO once, lactated ringer’s infusion 125 milliliters an hour intravenous continuous she has in order to insert an IV her current vital signs are blood pressure of 127 / 83 her temp is 99 degrees Fahrenheit her heart rate is 87 beats per minute her height is 62 inches and her weight is 233 pounds

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