CASE STUDY 1 Jen is a G7P5015 at 38 weeks gestation admitted to the labor and delivery unit for induction of labor due to gestational hypertension diagnosed today. Jen has a history of five spontaneous vaginal births.  A cervical exam is done, and Jen’s Bishop score is 7. What is the most appropriate interpretation of this assessment?

Case Study 3   Kiley is a G3P2002 at 39 weeks gestation.  She has no history of chronic hypertension.  Her blood pressure readings have been normal throughout pregnancy.  Today in the clinic, she had blood pressure readings of 144/88 with a repeat of 139/91.  She went to Labor triage for further assessment.  Four hours later her BP readings were 142/90, 146/85, 135/86.  Her protein: creatinine ratio is 0.28 mg/g.  Her serum creatinine and liver enzymes are elevated.  The provider has ordered magnesium sulfate, and you have started the 6 g loading dose and are ready to move on to implementing her plan for induction of labor.    Kiley has a history of one Cesarean birth and one vaginal birth after Cesarean.  Her Bishop score is 4.  Which of the following is an appropriate cervical ripening method for Kiley?

Case Study 5 Jessica is an 18-year-old G1P0000 at 33 weeks and 4 days. At 2330 she calls the nurse phone line and you answer. Jessica: “My stomach has been cramping a lot.”You: “When did you first notice it?”Jessica: “When I woke up, around 8 in the morning.”You: “Does the pain come and go, or is it always there?”Jessica: “It comes and goes, but it won’t go away even after I drank a lot of water.” What is your next response?

Case Study 3 Kiley is a G3P2002 at 39 weeks gestation with preeclampsia with severe features. Kiley has a history of one Cesarean birth and one vaginal birth after Cesarean.  She is receiving the maintenance dose of magnesium sulfate, and her induction of labor is in process with an oxytocin (Pitocin) infusion.  Her tracing looks like this.  As the nurse, what is your next step?

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