A 22-year old G2 P1 woman at 35 weeks gestation, who admits to cocaine abuse, complains of abdominal pain. She

 A 22-year old G2 P1 woman at 35 weeks gestation, who admits to cocaine abuse, complains of abdominal pain. She states she has been experiencing moderate vaginal bleeding, no leakage of fluid per vagina, and has no history of trauma. On examination, her blood pressure is 150/90 and HR is 110bpm. The fundus reveals tenderness and a moderate amount of dark vaginal blood is noted in the vaginal vault. The ultrasound examination shows no placental abnormalities. The cervix is 1-cm dilated. The fetal heart tones are in the 160-170 bpm range. 

see the attachment for a Templet sample of what to follow. it must be in a table form