Mary Smith presents in the Emergency Department of a regional hospital at 37 weeks' gestation, in established labor. She is not booked to birth at the hospital and does not live locally.

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Case history

Mary Smith presents in the Emergency Department of a regional hospital at 37 weeks' gestation, in established labor. She is not booked to birth at the hospital and does not live locally. She and her partner were visiting friends and had planned to drive home the next day. She has her antenatal records with her and is a diet controlled gestational diabetic.

Mary progresses quickly to second stage and begins pushing. After 1.5 hours, she is exhausted, and the obstetrician performs an episiotomy and instrumental delivery of a large male baby with an estimated birth weight of 4500g. He is floppy at birth but responds quickly to first response resuscitation techniques. He is admitted to the Special Care Nursery and has an initial temperature of 35.4°C and his first true blood glucose (TBG) is 1.3mmol/L.

Your task

Based on the case history respond to and discuss the following questions in relation to baby Smith's care:

  1. What factors may have impacted on Mary's labor and her baby's condition at birth?
  2. What nursing care would he receive in the first few hours of life?
  3. How could baby Smith's parents be involved in his care?

Solution

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