Simulation Scenario Assigned Assignment Help: How to Answer This Question

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Original Question

Simulation Scenario You are assigned to work in the Postpartum Couplet Care Unit. The patient is a 23-year-old female, G1P2, who is two hours post spontaneous vaginal delivery (NSVD) of viable male twins at 39.4 weeks gestation. Postpartum recovery period was within expected parameters with no episodes of unusual bleeding or clots. Admission orders have been written and are on the chart. Background Information: sheila harison labored effectively for 16 hours when she vaginally delivered twins, both cephalic presentations. Her blood pressure was slightly elevated in her last month of pregnancy, no other significant health history. In early labor, the client experienced increased blood pressure readings reaching 140/90 and trace urine protein noted. Blood pressure was carefully monitored during labor and noted to be stable with a range of 130-140/80-90. An epidural was placed at 3cm dilation. At 4 cm dilation, the patient experienced hypotonic labor and oxytocin augmentation of labor was instituted. At 9cm a straight catheter was inserted; 450 ml clear yellow urine output obtained. She had a third-degree laceration, repaired. Quantitative blood (QBL) loss following delivery was 375 ml. Connie plans on breastfeeding. Measurements Twin A (Apgar 8 and 9) weighed 3232 g (7 pounds, 2 ounces) Twin B (Apgar 7 and 9) weighed 3345 g (7 pounds, 6 ounces). Allergies NKDA Family Information Partner – jason Medical History Some elevated BPs no greater that 140/90 third trimester. Home Medications Prenatal vitamin with Iron Diagnosis – Postpartum Hemorrhage Complete the following table prior to Simulation to understand the pathophysiology and expected management Definition/ Pathophysiology Cause(s) Signs & Symptoms Diagnostics & Lab Tests Treatment plan Growth, Development & Normative Values Complete the following table prior to simulation to understand expected infant development and care considerations Infants (0-12 months old) Common health concerns Safety/ Anticipatory Guidance Heart Rate Respiratory Rate Temperature (axillary) Medications & Fluids Complete the following table using resources. Oxytocin Common Brand Name(s) Drug Class/ Reason for Use Route(s) Nursing Assessments & Evaluation Common Side Effects Administration Considerations Is this medication appropriate for this patient? Safe Dose Range TXA Common Brand Name(s) Drug Class/ Reason for Use Route(s) Nursing Assessments & Evaluation Common Side Effects Administration Considerations Is this medication appropriate for this patient? Safe Dose Range per formulary Misoprostol Common Brand Name(s) Drug Class/ Reason for Use Route(s) Nursing Assessments & Evaluation Common Side Effects Administration Considerations Is this medication appropriate for this patient? Safe Dose Range per formulary Methergine Common Brand Name(s) Drug Class/ Reason for Use Route(s) Nursing Assessments & Evaluation Common Side Effects Administration Considerations Is this medication appropriate for this patient? Safe Dose Range per formulary Carboprost Common Brand Name(s) Drug Class/ Reason for Use Route(s) Nursing Assessments & Evaluation Common Side Effects Administration Considerations Is this medication appropriate for this patient? Safe Dose Range per formulary Critical Thinking Questions: What physical assessments are vital for the nurse to perform on the postpartum family? Why? What are common postpartum complications? What are expected physical findings with 2 hour post-birth infants? What are some considerations for effective teamwork in an emergency situation? Plan of Care Using the information above, identify anticipated priority nursing diagnoses (one physiological and one psychosocial). Nursing Diagnoses/ Problems Expected Outcomes Interventions and Rationales Evaluation Problems should include signs/ symptoms and your assessment data as evidence to support Expected outcomes should be client-specific, measurable, realistic and time-limited Interventions should be specific, relevant to nursing diagnosis, and include frequency of implementation Evaluation should describe reassessments that will determine effectiveness of interventions

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