Clinical Scenario HELP!

[MsStephanie29]

I'm in OBGYN this quarter and I need help creating accurate nursing diagnosis for my clinical scenario!

The patient is a 38 year old Gravida 2 Para 1 @ 38weeks gestation.She came to the hospital because she has brightred lady partsl bleeding that began approximately 1hour ago. Baby is in vertexpresentation.

Vital signs are: T36.8 C(98.2F), P112, R24, BP88/48, O2 sat = 93%.

Hemoglobin=9,Hematocrit=30Patient appears pale andanxious.

Peripad is filled with blood and mucoid substance (bloody show). The patient deniesabdominal pain. She statesshe has an occasional mildcontraction. FHR 150 with minimal variation. By palpation,the abdomen is soft, nontender.

I've started with these nursing diagnosis:

1.Ineffective tissue perfusion, related to anemia, manifested by a pale skin color and a decreased hemoglobin concentration in the blood.

2.( I can't show you the strip)

Risk for fetal injury related to non-reactive strip accompanied by minimal variability manifested by fetal heart rate 150 and without any accelerations for 7 minutes.

3.

Risk for hypovolemia, related to blood loss, manifested by pale appearance, hypotension, and tachycardia.

The first should be the most important and so on. Any suggestions? I've come to a road block !!!

[Kuriin, BSN, RN]

I like the way you're thinking. Can you tell me what you think this patient may be experiencing?

[MsStephanie29]

Latent stage because she's in no pain and fairly alert however my textbook mentions that if the mother has a bloody show it's the transitional stage which is quite confusing.

[Kuriin, BSN, RN]

I'm not great in maternity...but, whenever I see "bright red bleeding" with no pain can be pretty serious and potentially needs an immediate C-Section.

edit: BTW, the nursing diagnoses are good IMHO.