Normal Labor and Delivery Case Study #1 - Zinna Zinna is a 19 year-old, G1P0, MWF (married white female) at 39 weeks gestation. Her pregnancy has been uneventful. Zinna prides herself on having taken very good care of herself during her pregnancy. Zinna is five feet three inches tall and weighs 138 pounds, having gained 22 pounds during the pregnancy. Zinna calls her midwife’s office to tell her that she has been having contractions for several hours. She tells the nurse that the baby is active, and although she cannot really rest because of the contractions, she feels she is doing very well. Zinna has planned a hospital delivery with the certified nurse midwife (CNM). 1) What does gravida and para refer to? Zinna is a G1P0, what does this represent? 2) What is gestation? 3) How many weeks gestation is a full term pregnancy? 4) How many weeks gestation is a preterm or premature labor and how many for a post term labor? 5) Is Zinna’s pregnancy full term, preterm, or post term? 6) While on the phone with Zinna, list three questions the nurse should ask her at this time. 7) When should Zinna be instructed to go to the hospital? 8) Zinna has attended childbirth education classes. She plans to use nonpharmacologic method for pain relief during her labor. What is the advantage to parents who attend childbirth education classes? What are the pros & cons of using nonpharmacologic pain relief measures during labor? 9) Zinna has developed a birth plan and discussed it with her certified nurse midwife (CNM). Zinna prefers the use of intermittent fetal monitoring. Discuss the pros and cons of using continuous electronic fetal monitoring in labor versus intermittent fetal monitoring. 10) Zinna has also asked that she be allowed to not have an IV in labor. Her CNM has agreed to this. Discuss the pros and cons of routine IV in labor. 11) Furthermore, Zinna has asked to be able to eat lightly and drink high-energy liquids in labor. Discuss the pros and cons of this. 12) Several hours later, Zinna calls the office again to say that she feels she should go to the hospital. Her “contractions are coming every three minutes and are lasting from one minute to 90 seconds”. When she arrives at the hospital she is found to be 6 cm dilated, completely effaced, and the baby is a +1 station. Her membranes are intact. The CNM gives her the option of having her membranes ruptured at this time. Discuss the pors and cons of this intervention. 13) The nurse is checking the fetus and Zinna’s contractions intermittently. How often should they be assessed? 14) How are contractions assessed in labor? 15) After two hours of continued strong contractions Zinna is completely effaced and 10 cm dilated. Zinna says she is tired, doesn’t feel like pushing, and wants to rest prior to pushing. Discuss the pros and cons of allowing her to rest at this time.