You arrive on the scene and find a 23-year-old female patient complaining of contractions. She is…

You arrive on the scene and find a
23-year-old female patient complaining of contractions. She is obviously
pregnant. She states she is due in 2 weeks. She is alert but uncomfortable. Her
respirations are 24 per minute. Her radial pulse is 128 per minute and her skin
is warm and slightly moist. She indicates the contractions began in the middle
of the night, about 6 hours ago, and have progressively worsened in intensity
and increased in duration. The contractions are also more frequent. This is her
first pregnancy. She has no allergies, is on a beta2 agonist metered-dose
inhaler, and has a
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You arrive on the scene and find a
23-year-old female patient complaining of contractions. She is obviously
pregnant. She states she is due in 2 weeks. She is alert but uncomfortable. Her
respirations are 24 per minute. Her radial pulse is 128 per minute and her skin
is warm and slightly moist. She indicates the contractions began in the middle
of the night, about 6 hours ago, and have progressively worsened in intensity
and increased in duration. The contractions are also more frequent. This is her
first pregnancy. She has no allergies, is on a beta2 agonist metered-dose
inhaler, and has a history of asthma. Her last oral intake was approximately 2
hours ago when she had two pieces of toast and some juice. She has been lying
in bed because of the discomfort. She states that when she lies on her back she
feels very light-headed. Her blood pressure is 108/62 mmHg and her SpO2 is 98%
on room air. Upon inspection, you note the vaginal walls and perineum are
bulging and the infant’s head is present at the vaginal opening. You note the
sheets are soaked in fluid, and there is a light green tarry substance in the
fluid.

1. What signs would lead you to
believe the labor is true labor and not Braxton-Hicks? 2. Why is she
experiencing light-headedness? 3. How would you proceed with the emergency care
of the patient? 4. What signs are indicative of imminent delivery? 5. What is
the significance of the green substance in the fluid on the sheets?

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