Pharmacology Made Easy 4.0: Reproductive and Genitourinary
Problem Based Scenario
Directions: With your small group, complete this worksheet utilizing information from your Module
Worksheet, the Active Medication Templates, and class lecture.
Clinical Scenario #1: Mikayla is a 27-year-old, G2 P0 at 38 weeks gestation. She is being admitted for an
induction of labor (IOL) for oligohydramnios. A sterile vaginal exam (SVE) shows her cervix is closed,
50% effaced, -2 station, firm and posterior.
Noticing:
1. What are the risks associated with oligohydramnios for Mikayla and her baby?
The risk for Mikayla and the baby is still birth, immaturely developed fetal lungs, and
poor fetal growth. There can also be kidney and urinary tract malformations that
contribute to the oligohydramnios.
Interpreting:
2. What is Mikayla’s Bishop score based on these findings?
The bishop score is a 2
3. How does a Bishop’s score help to determine which medication will be used for an induction of
labor?
The bishop score helps to determine how favorable your body is when being induced for
labor. If you score over 6 then your body is favorable to being induced and having a
vaginal birth happen after. If the score is lower than 6 then the mor medication and time
it will take to get your labor started, this also means that you are more at risk for a c-
section.
, 4. Is it always necessary to perform a SVE prior to an induction of labor?
Yes, because you need to know what the bishop score is and you need to determine
where the patient is starting at. This will help you to be able to determine progress once
the medication is started and the medication to use to induce the labor.
5. The healthcare provider orders the following:
Dinoprostone 10 mg vaginal suppository
6. Which of the following conditions would the nurse notify the healthcare provider as a
contraindication for the use of dinoprostone vaginal insert or gel? Select all that apply
1. Late decelerations on the fetal monitor
2. Ultrasound at 34 weeks showed fetus in breech presentation
3. Presence of oligohydramnios
4. History of asthma
5. Pregnancy has not reached 40 weeks gestation
Interpreting
7. After discussing her plan of care with the provider, Mikayla appears confused and asks the nurse
“What is the purpose of me getting this medication and how will we know it’s working?” How
should the nurse respond?
The purpose of this medication is to start the thinning and opening of your cervix to
allow your uterus to start contracting and stimulate labor. We will monitor your baby’s
heart rate, your contraction and for any cervical changes to determine how effective the
medication is and if it is progressing you towards labor.
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