ABRUPTION PLACENTA The initial 15 min of CTG shows a baseline of 145/min with normal variability (12/min) and no visible acceleration or decelerations. Following this there is a drop in fetal heart rate to 70/min for 7 min before gradual recovery to 125/min. This is a previously low-risk pregnancy and this CTG shows a fetal bradycardia (reduction in baseline heart rate to below 100/min). Formulate 5 Specific Nursing Diagnosis base on the case presented. Its order should be according to the priority of the problem.

A 22-year-old woman in her second pregnancy has arrived on the labour ward at 38 weeks 3 days. She had a normal delivery 18 months ago. This pregnancy has been complicated by persistent vomiting until 20 weeks and more recently by anaemia. She reports contractions commencing approximately 4 h ago. She took paracetamol at home and tried to relieve the pain with a bath, but now feels she cannot cope with the pain. She had a show 2 days ago but has had no bleeding since then and has not noticed any vaginal leak. She has felt the baby moving normally all day. Examination The blood pressure is 110/58 mmHg and heart rate is 98/min. The presentation is cephalic with 2/5 palpable abdominally. Uterine contractions are palpable and the uterus is non- irritable. On vaginal examination the cervix is 5 cm dilated and the head is 1 cm above the ischial spines. The fetal position is right occipitotransverse with mild caput and mould- ing. The membranes are intact but rupture spontaneously during examination, with clear liquor draining. The woman requests an epidural for pain relief and is therefore commenced on continuous cardiotocograph monitoring. After 20 min you are called in to review the situation.

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