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Pregnancy Scenario

Follow the instructions provided below:

A. Solid academic writing is expected and in-text citations and references should be presented using APA documentation guidelines. Respond to other student?s post.

B. Answer the questions of this scenario:

Your patient, Mrs. Winters, is a 31 year old female who is 189 days pregnant with a baby boy. Her date of conception was March 23, 2013. Mrs. Winters in complaining of abdominal pain and cramping radiating to her back for approximately 3 hours. She denies any vaginal bleeding or discharge. Mrs. Winters tells you her OB doctor has informed her that the baby has a ductus arteriosus malformation that could lead to PDA during delivery.

BP = 82/46

HR = 122

RR = 24

SpO2 = 98%

Sinus Tachycardia on monitor.

Please answer the following questions about the above scenario.

1. What is Mrs. Winter’s EDD?

2. What pregnancy complication is Mrs. Winters Experiencing? (give a rationale for your answer) 3. What is surfactant and why is it important in this scenario

4. Why is Mrs. Winter’s fetal history off possible PDA during delivery important to you as a paramedic?

5. What equipment and why would you need if birth is imminent.

C. This is the student post:

1- If Mrs. Winter?s date of conception was March 23, 2013, then her estimated due date is on December 14, 2013

2- It is important to consider that Mrs. Winter is on her 27th week of pregnancy. During the 27th week of pregnancy, a lot of changes are also happening inside the body. Before the end of the second trimester, the increased needs of the fetus can place a burden on the mother?s lungs, heart, and kidneys. The physical changes as well as the hormonal changes cause abdominal pain which can radiate to the back portion and even to the posterior pelvic region (, 2012). This pain can even worsen before the day ends. In this situation, the mother is advised to take some bed rest. On the other hand, careful monitoring is still necessary since there are slight increases in the vital signs of the patient compared to the normal values. It is also likely possible that Mrs. Winter is experiencing pre-term labor. When a woman is in pre-term labor, there are regular contractions which cause the pain in the abdomen (, 2013). Since there is no vaginal discharge, ectopic pregnancy is not likely the case (, 2013).

3- When the baby is born at a premature stage, the lungs have not yet made enough surfactant, a lipoprotein present in the lungs. When there is low surfactant, the lungs are unable to function well. When this happens, the lungs can likely collapse and there will be increased amount of fluid in the lungs causing difficulty in breathing (, 2008). Surfactant is added to the baby?s lungs to compensate for that which was not formed due to premature birth.

4- It is important to know the possibility of Patent Ductus Arteriosus to alert the paramedic of the necessary equipment to take and the approaches to apply. When there is PDA, there is abnormal flow of blood between the two major vessels ? aorta and pulmonary artery – that carry blood from the heart (, 2011). In a premature baby with PDA, this can lead to difficulty in breathing.

5- As a paramedic, I will bring with me a C-PAP, a pediatric BVM, and oxygen tank that will assist the premature baby in breathing if breathing is not evident. If the baby is able to breathe properly yet still needs extra oxygen, a pediatric nasal cannula attached to oxygen can be useful.



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