Care Plan Post Assignment Help: How to Answer This Question
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Original Question
Care Plan – Post Partum Patient: Sara Age: 28 Admission Dx: Induction of labor at 38.0 for gestational diabetes & hydramnios Med/OB hx: G4 T2 PO A1 L2 A1 GDM and LGA (4102 Gram) baby with 1st pregnancy 4 vaginal deliveries Blood: A- GBS + (treated x 4) TORCH STI – negative Delivery Summary: Pt admitted 2 nights ago and induced with misoprostol x 3 doses (q4 hours apart) , then augmented with oxytocin infusion. Received an epidural at around midnight last night. AROM at 0330 with light meconium . Mostly a CAT I tracing but with recurrent variable decelerations after AROM. Amnio infusion given at 0440 . Pt was 10/100 /-1 at 0515 and began pushing shortly after. CAT II tracing for most pushes toward the last 15 minutes before delivery r/t variable decelerations . O2 and fluid bolus given. Vacuum applied due to maternal exhaustion -3 push/pulls performed (no pop-offs).Shoulder dystocia noted after delivery of head; McRoberts positioning and supraprubic pressure applied successfully. Pt delivered a viable baby girl at 0625, placenta out in 22 min. Pitocin bolus given . Baby: 4200 g, APGAR 7/8 (for tone and color) Hep B, Vit K and Erythromycin given, doe not move left upper extremity; significant molding and caput 1) What are the main concerns that you know of for Sara upon receiving report that will direct your assessment priorities when you go in to meet her and her new baby. (5 points) 2) What would be a nurses responsibility during a normal vaginal recovery (think vital, fundal check, medications, etc.) 5 points. At the fundal check at 715, the nurse has the following findings: The patient is reporting that she is nauseous. You take her BP and it is 95/60 , Her fundal massage is boggy. and her uterus is displaced to the right. She has soaked the pad that was placed after delivery. The blood is dark red and has clots. 3) Based on the above situation, list the top 3 interventions the nurse must perform in order of priority in the event of a PPH Post partum hemorrhage. STATE YOUR REASONING for each intervention, and its place in order. A – B – C – After applying all nursing interventions, the physician is called and returns to the patients bedside. 4) What 3 medications would you expect the physician to administer ? Include any questions, you might ask BEFORE administering the medications. 4 points, A – B – C – D – The physician is unable to get the patients bleeding to stop. 5) What would you expect to happen next? 2 points. 6) Write out a nursing dx for this patient. Use complete sentences and NANDA phraseology. A- Diagnosis: B – R/T : As evidenced by: Objective: (1) Subjective: (1)
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