What are the next steps in evaluation of this patient?

Dear writer, I need a discussion reply to a fellow classmates’ class discussion post for an FNP OB-GYN class. Please, do not critique their paper but rather expand on their original point and or add your opinion. I will attach their post and the class discussion instruction they are answering to, to which you are to reply to the students post. Please do not speak in third person but rather use words like… I agree with you, In addition id like to add… Interesting point you bring up. or whatever else youd like to add. Just make it seem like i am answering their to their postClass instructions:A healthy, 28-year-old patient presents to labor and delivery at 39 weeks of gestation complaining of “campiness” overnight. Her vital signs are all stable. The fetal heart tracing is reassuring, and there do not appear to be any regular contractions. What are the next steps in evaluation of this patient? If it appears, she is in labor, discuss your management plan for this patient, including pharmacologic and follow ups.Student post you are to reply to:Symptoms of overnight “crampiness” can be concerning for a pregnant woman, especially if this is the first instance of cramps. They are probably Braxton Hicks contractions, not true contractions, but the provider should assess further. It is important to ask about any other events that could suggest labor, such as increased vaginal fluid or a burst of fluid, indicating rupture of membranes. The provider should review the patient’s records looking for any history of complications during the pregnancy, including lab history. The provider should then do a focused review of systems and a physical exam (Bechmann et al., 2014, pp. 93-94).When examining the abdomen the provider can do Leopold maneuvers to determine the position, presentation, and lie of the fetus. During the vaginal exam the provider should check for effacement, which is when the cervical canal shortens, and for dilation of the cervix. The fetal station should be checked as well (Bechmann et al., 2014, pp. 94-95).If the patient is determined to be in active labor the provider should remain accessible. The patient should be educated to not drink anything except for limited amounts of clear fluids or ice. If oral intake is not sufficient, and dehydration is a concern, then the provider should order IV fluids. If there are no risk factors the fetal heart rate should be auscultated every 30 minutes during the first stage of active labor, and at lest every 15 minutes during the second stage. An electronic fetal monitor may be used, but is not necessary for a term pregnancy that is low-risk (Bechmann et al., 2014, p. 99).The provider should discuss methods of pain control with their patient. Some patients may not want pharmacologic pain management. However, if the patient would like a form of anesthesia or analgesia the provider should contact the anesthesiologist or nurse anesthetist (Bechmann et al., 2014, p. 99). The provider should be familiar with non-pharmacological pain management, such as massage, acupressure, hypnotherapy, and breathing techniques (Adams, Frawley, Steel, Broom, & Sibbritt, 2015).After a successful vaginal delivery, the healthcare team should continue to monitor the mother for post-partum complications. Blood loss and blood pressure should be closely monitored for several hours after delivery (Bechmann et al., 2014, p. 103). The mother should be assessed for pain after delivery and pharmacologic and non-pharmacologic options should be offered. The mother will likely stay in the hospital for 48 hours and before discharge the baby should have follow-up appointments with the pediatrician already scheduled (Bechmann et al., 2014, pp. 130-131).The postpartum visit is important, and one of Healthy People’s 2020 goals is to increase the number of women who attend a postpartum visit. Individuals at higher risk for not attending a postpartum visit include those of younger age, low-income, minority populations, and those who did not receive prenatal care. Guidelines vary on when the best time for the postpartum visit to take place is, but several guidelines recommend it occur between the 4th and 6th weeks after delivery (Stumbras, Rankin, Caskey, Haider, & Handler, 2016). At the mother’s postpartum visit the provider should discuss breastfeeding, sexual activity, menstruation, physical activity, family dynamics, contraception, and feelings of sadness or anxiety (Bechmann et al., 2014, p. 135). ReferencesAdams, J., Frawley, J., Steel, A., Broom, A., & Sibbritt, D. (2015). Use of pharmacological and non-pharmacological labour pain management techniques and their relationship to maternal and infant birth outcomes: Examination of a nationally representative sample of 1835 pregnant women. Midwifery, 31(4), 458–463. doi:10.1016/j.midw.2014.12.012Bechmann, C.R., Ling, W. F., Herbert, N. W., Laube, W. D., Smith, P. R., Casanova, R., & Weiss, M.P. (2014). Obstetrics and gynecology (7th ed.). Philadelphia, PA: Lippincott, Williams, & Wilkins.Stumbras, K., Rankin, K., Caskey, R., Haider, S., & Handler, A. (2016). Guidelines and interventions related to the postpartum visit for low-risk postpartum women in high and upper middle income countries. Maternal & Child Health Journal, 20, 103–116. doi:10.1007/s10995-016-2053-6