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Western Mindanao State University

College of Nursing
Zamboanga City

Alternative Learning System

Related Learning Experience
OBSTETRICS-GYNECOLOGICAL AREA

Instructions:
Answer the provided questions comprehensively following the subsequent format.
A. Use the Times Roman Font Style with 12-point font size, 1.5 spacing, 8.5 x 13 size
B. Utilize at least three (3) or more references
C. References should be 2015 and latest
D. Refer to page 2 for the rating system of your output

A. CASE SCENARIO: Shoulder Dystocia (Intrapartum Period)

Mrs. L, a 36-year old, G3P2 patient at 39 weeks AOG, was admitted for induction of labor.
IVF of 0.9% NaCl, 1 liter was incorporated with 20 iu of oxytocin to run at 10 - 15 gtts/ minute.
She had a previous history of delivering two 9 lb. babies within the last 6 years. She remembers
that the deliveries were “difficult” and she had a tear in the cervix and bled a lot. Mrs. L has a
documented 50 lbs. weight gain during this pregnancy. Upon assessment, vital signs were as
follows:

Vital signs:
Blood pressure (BP) : 140/60 mmhg
Pulse rate (PR) : 100 bpm
Respiratory rate (RR) : 21 b/min
Temperature : 36.8 0 C

Patient’s blood glucose result was 200 mg/dl. She was diagnosed with gestational diabetes at
26 weeks and was prescribed Metformin (Glucophage) 500 mg PO TID. An ultrasound was done
two weeks ago (at 37 weeks.) because her fundic height was 36 cm. Her ultrasound result
showed that the estimated fetal weight was 4,000 grams. Upon internal examination the patient
presents the following findings:
Time Cervical Dilatation Effacement Station
8:30 AM 5 cm cervical 90% effaced +1 station
dilatation
9:30 AM fully dilated cervix completely effaced + 1 station

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 The patient pushed for every contraction which lasts for an hour and yet no progress. The
physician applied forceps to assist with delivery and descent, after 3 contractions the head of the
baby is delivered. The head advances slightly then retracted back up “turtling” and the shoulders
did not come out. The physician requests for supra-pubic pressure and McRoberts maneuver to
be done. The baby was delivered @ 9:45 am with an Apgar Score of 7-8 and birth weight of 4,
200 grams.

Past Medical History:

1. History of gestational diabetes in the previous pregnancy
2. History of delivering macrosomia baby in the past pregnancies
3. Overweight

Ultrasonography Result
Last Menstrual Period: September 5, 2019
Expected Date of Delivery: June 12, 2020

Impression: Single, Live uterine pregnancy with normal and regular cardiac activity
Presentation: Cephalic
Amniotic fluid: Normal
Fetal Movements: Present
Fetal weight: 4, 000 grams
Gestational Age: 37 weeks
Fetal heart rate: 140 beats/minute

STUDENT’S TASKS:

 Make a Study of Illness Condition.

 Formulate a Nursing care plan based on the NANDA approved Nursing Diagnosis.
 Give at least two (2)
 PRIORITIZE the problems and cite your reference/s
 Develop a Drug Study based on your patient’s case presented.

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Note: Follow these formats given:

STUDY OF ILLNESS CONDITION

ASSESSMENT ANATOMY PHYSIOLOGY PATHOPHYSIOLOG ANALYSIS
Y
 Signs and  Illustrate and  Normal  Include the  Correlate the
Symptoms label function of the diagram of the patient’s sign
manifested by organ involved following: and symptoms
the patient.  Pathogenesis to the disease
 Lab results  Life- condition
 Diagnostic threatening  Discuss the
procedures pathways indication for
the lab exam
 Explain the
significance of
the abnormal
results

Cite Reference/s Cite Reference/s Cite Reference/s Cite Reference/s Cite Reference/s

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 NCP FORMAT
ASSESSMENT NURSING PLANNING IMPLEME EVALUATION
DIAGNOSIS NTATION
OBJECTIVE INTERVEN RATIONALE
OF CARE TION

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 DRUG STUDY FORMAT

GENERIC NAME MECHANISM OF SIDE NURSING

ACTION EFFECTS RESPONSIBILITY

BRAND NAME INDICATION

DRUG ILLUSTRATION CONTRAINDICATION ADVERSE

REACTION

CLASSIFICATION

DOSAGE/FREQUENCY/ROUTE

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 B. Rubrics for ALS (OB-GYNE)

4 3 2 1
Follows and
Exceeds Follows some Demonstrates
CATEGORY Follows
expectations but not all little
instructions
noted in instructions comprehension
instructions
I. STUDY OF ILLNESS CONDITION (total score = 48 points)
1. Assessment
 Differentiates between subjective and objective
cues
 Analyzes laboratory examinations
2. Anatomy
 Indicates and labels the affected organ
 Cites reference/s & Paraphrases
3. Physiology
 Discusses the normal functions of the organ
involved
 Cites reference/s & Paraphrases
4. Pathophysiology
 Explains the pathophysiology based on the
diagnosis
 Develops the pathologic pathway of the
patient’s current illness
 Synthesizes the life-threatening pathway as a
consequence of the patient’s refusal / non-
compliance with treatment
 Cites reference/s & Paraphrases
5. Analysis
 Correlates signs & symptoms to the illness
condition
 Relates laboratory / diagnostic exams to the
illness condition
TOTAL POINTS

4 3 2 1
Follows and
Exceeds Follows some Demonstrates
CATEGORY Follows
expectations but not all little
instructions
noted in instructions comprehension
instructions
II NURSING CARE PLAN (total score = 36 points)
6. Nursing Care Plan (2)
 Utilizes the Nursing Process

 Assessment

 Diagnosis
 Planning
 Objective of Care
 Interventions
 Rationale
 Implementation
 Evaluation
 Cites reference/s
TOTAL POINTS

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 4 3 2 1
Follows and
Exceeds Follows some Demonstrates
CATEGORY Follows
expectations but not all little
instructions
noted in instructions comprehension
instructions
III. DRUG STUDY (total score = 12 points)
7. Drug Study
 Comprehensive drug information and cites
references
 Nursing Responsibilities
 Indication / contraindication
TOTAL POINTS

Prepared by:
Level II Faculty

Noted by:

FREDIE M. OMAR,MAN, MN
Curriculum Chair

Approved by:
DR. MARY JOSELYN C. BIONG
Dean, College of Nursing

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