What Independent Dependent Question & Answer Guide (With Explanation)
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Original Question
What is the Independent, Dependent, and Collaborative Intervention with the Rationale of this given Case Scenario? (Assessment, Diagnosis, Planning, and Evaluation are already included) Case Scenario – Umbilical Cord Prolapse A 32-years-old pregnant woman, G2P1(L1) and at 39 5/7 weeks of gestation, was admitted for the delivery at 10 AM. She is in active labor. Her vital signs are BP: 135/81 mmHg, HR: 90, RR: 16, Temp.: 37°C, SpO2: 97%, FHR: 89. She verbalized that something is coming through her vagina. She and her spouse express confusion and anxiousness about the situation as this is the first time they experienced this condition. The patient does not have any significant health history related to cord prolapse besides the provider did the artificial rupture of the membranes recently. The result of her assessment shows that the patient has an umbilical cord presenting while assessing the vagina. FHR is variable nonreassuring, and everything else is unremarkable. The excessive fetal movement is followed by no fetal movement, suggesting that the fetus is suffering from hypoxia. The provider has ordered bed rest, ice chips, Nalbuphine 10mg IVPB Q 1-2, Lactated Ringer’s 1000 ml IV 125 ml/hr continuous infusion. Assessment: Subjective: Patient verbalizes that she feels something is coming through her vagina Objective: BP: 135/81 mmHg HR: 90 beats per minute RR: 16 breaths per minute SpO2: 97% FHR: 89 beats per minute Excessive to no fetal movement Diagnosis: Decreased cardiac output related to low fetal heart rate Planning: Short term: After 2 hours of nursing intervention, the fetus will: Demonstrate increased cardiac output as evidenced by an increase in fetal heart rate within 110 to 130 bpm. Maintain regular fetal movement as evidenced by a biophysical profile score of 8 to 10. Long term: After a week of nursing intervention, the newborn will: Exhibit pinkish and warm skin and regular activity level as evidenced by 14 to 17 hours of sleep, regular eating patterns, and presence of newborn reflexes, such as sucking reflex and rooting reflex Display adequate breathing patterns as evidenced by the absence of adventitious breath sounds. Evaluation: After 2 hours of nursing intervention, the desired goals were met as evidenced by: The fetus demonstrated increased cardiac output with an increase in fetal heart rate within 110 to 130 bpm. The fetus maintained regular fetal movement with a biophysical profile score of 8 to 10. After a week of nursing intervention, the desired goals were met as evidenced by: The newborn exhibited pinkish and warm skin and regular activity level with 14 to 17 hours of sleep, regular eating patterns, and the presence of newborn reflexes, such as sucking reflex and rooting reflex. The newborn displayed adequate breathing patterns with no adventitious breath sounds.
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