Questions
Mrs. X, 36 year old women with obstetrical score G8P7 got admitted to the labor room...

Mrs. X, 36 year old women with obstetrical score G8P7 got admitted to the labor room in her active phase of labor at 39 weeks of gestation. She had a previous history of PPH. During this pregnancy she developed GDM. Labor progressed quickly as she is a grand multipara and a baby boy of 4 kg weight was delivered vaginally with vacuum assistance. She has an episiotomy too. Placental delivery followed in another 10 minutes. Patient already on oxytocin drip with 20 units diluted in RL solution timed at a rate of 125 ml/min. 20 minutes after delivery, Ms. X, passed large clots.
ASSESSMENT
1. What are the possible risk factors of PPH you would identify from the case study? List them.
2. Based on the observed risk factors and h/o of PPH, what immediate examination and interventions would you plan and why?
DIAGNOSIS
History:
On admission, the mother was in 39 weeks of gestation already in the active phase of labor. This is her 8th Gravida and already has 7 living children. Her past obstetrical history from the green card revealed severe PPH in the previous pregnancy 2 years back. In the current pregnancy she is diagnosed with GDM. As she was a grand multipara, the labor progressed quickly and she delivered a baby boy weighing 4 kg by assisted vaginal delivery (Vacuum) with episiotomy.
Examination:
Exactly 20 minutes after the delivery, it was observed that the Mrs. X, passed large clots with her BP going down steadily 100/60, pulse is 90 beats /min. But the patient hasn’t developed shock yet but likely to develop if not intervened immediately.
4. Based on this clinical scenario, frame the nursing diagnosis and your plan of care?
5. What would be the health education you would like to give to this patient?

Mrs. X, 36 year old women with obstetrical score G8P7 got admitted to the labor room in her active phase of labor at 39 weeks of gestation. She had a previous history of PPH. During this pregnancy she developed GDM. Labor progressed quickly as she is a grand multipara and a baby boy of 4 kg weight was delivered vaginally with vacuum assistance. She has an episiotomy too. Placental delivery followed in another 10 minutes. Patient already on oxytocin drip with 20 units diluted in RL solution timed at a rate of 125 ml/min. 20 minutes after delivery, Ms. X, passed large clots.
ASSESSMENT
1. What are the possible risk factors of PPH you would identify from the case study? List them.
2. Based on the observed risk factors and h/o of PPH, what immediate examination and interventions would you plan and why?
DIAGNOSIS
History:
On admission, the mother was in 39 weeks of gestation already in the active phase of labor. This is her 8th Gravida and already has 7 living children. Her past obstetrical history from the green card revealed severe PPH in the previous pregnancy 2 years back. In the current pregnancy she is diagnosed with GDM. As she was a grand multipara, the labor progressed quickly and she delivered a baby boy weighing 4 kg by assisted vaginal delivery (Vacuum) with episiotomy.
Examination:
Exactly 20 minutes after the delivery, it was observed that the Mrs. X, passed large clots with her BP going down steadily 100/60, pulse is 90 beats /min. But the patient hasn’t developed shock yet but likely to develop if not intervened immediately.
4. Based on this clinical scenario, frame the nursing diagnosis and your plan of care?
5. What would be the health education you would like to give to this patient?

In: Nursing

I need to find an easy peer-reviewed article related to pharmacology and discuss the article and...

I need to find an easy peer-reviewed article related to pharmacology and discuss the article and how it can or cannot impact your nursing practice.

preferabley a free text article but any help would be appreciated

In: Nursing

Describe the steps of the evidence-based research process and the importance of using them. In the...

Describe the steps of the evidence-based research process and the importance of using them. In the initial stages of an EBP project, where do nurses in your specialty go to locate sources of information that help them to determine whether or not a practice problem is appropriate for an evidence-based practice change proposal. Include two specific sources on information in your discussion.

In: Nursing

Prolapse Janice a 78-year-old G4 P4 presents to the office with a complaint of urinary frequency,...

Prolapse

Janice a 78-year-old G4 P4 presents to the office with a complaint of urinary frequency, urgency and a sensation of feeling as if she is sitting on a ball. She states she feels pressure in her lower abdomen and back. She is very healthy and tries to exercise but has been limited secondary to discomfort.

Past Medical History

  • Hypothyroid
  • Constipation
  • Psychosocial history is negative

Medications

  • Levothyroxine
  • Calcium
  • Vitamin D

Answer These Questions

  1. What other subjective data do you need to gather today?
  2. What objective data would you gather today?
    • Assessment Findings:
      • PE is T 98.6 P 82, R 16, B/P 112/74
      • Abdomen soft NT without masses
      • Pelvic assessment reveals – female external with urethral caruncle
      • Vulva is negative with loss of labial folds secondary to atrophy – no obvious abnormalities
      • Scant vaginal discharge, atrophic, moderate vaginal vault prolapse.
      • Cervix is primiparous - CMT
      • Cervix is primiparous - CMT
      • Uterus small, non tender no masses
      • Ovaries non palpable
      • Rectal negative
      • On Valsalva - +grade 2 cystocele
  3. What is your assessment of this patient? Include 1CD10 code and rationale.
  4. Your patient states she doesn't want any surgical intervention. Complete a plan of care for this patient including, diagnostics, pharmacological and non-pharmacological treatment, education, including primary and secondary prevention, referrals, and follow up.

In: Nursing

Dr. Jim Witcher was a 57-year-old retired veterinarian who owned a horse farm in Louisiana. He...

Dr. Jim Witcher was a 57-year-old retired veterinarian who owned a horse farm in Louisiana. He had amyotrophic lateral sclerosis (ALS, sometimes called Lou Gehrig's disease), which was gradually causing him to lose muscle control. He had been active on his farm and enjoyed caring for his horses but was now wheelchair-bound in a power-assisted chair. He could, with assistance, get out on his farm but was losing the ability to feed himself. He worried about his gradual decline and loss of control. He also worried about the enormous costs that were depleting the resources set aside to support him and his wife during their retirement.

His wife provided around-the-clock care. She resisted suggestions that she place her husband in a nursing home or even hire help for his care. Their children were grown and occupied, raising their own families. Dr. Witcher knew the burdens on his wife were enormous.

Dr. Witcher realized that he would soon lose all ability to consume food and medicine unaided and anticipated the day when he would not be able to hold his grandchild or even breathe on his own. He knew what he did when one of the horses under his care developed an incurable disability. One day during a routine visit with his internist, he raised the question of why humans could not get similar assistance to quickly end their misery when their suffering and disability became unbearable.

              

               d) Out of all the ethical principles covered in the course thus far, which should be applied here to yield the most ethically acceptable decision? Provide justification for your response.

               e) What is the strongest objection to the view that you defended in part (d)? Describe this objection and respond to it in defense of your view.

In: Nursing

learning principles about dementia

learning principles about dementia

In: Nursing

Q: 4   Design an educational program for changing the self-assessment apps use behaviour of students according...

Q: 4   Design an educational program for changing the self-assessment apps use behaviour of students according to the prevention and control of COVID-19 based on the activated health education model? With at least 2 references , at least 4-5 line answer

In: Nursing

Q: 5   Design an educational program for changing the stay behaviour of students according to the...

Q: 5   Design an educational program for changing the stay behaviour of students according to the prevention and control of COVID-19 based on the theory of planned behaviour. With at least 2 references, at least 4-5 line answer

In: Nursing

Q: 6 Design an educational program for changing the social distancing behaviour of students according to...

Q: 6 Design an educational program for changing the social distancing behaviour of students according to the prevention and control of COVID-19 based on the transtheoretical model of change. With at least 2 references, at least 4-5 line answer

In: Nursing

, identify and briefly discuss the economic impact of drug use and abuse in the USA...

, identify and briefly discuss the economic impact of drug use and abuse in the USA from a medical/health perspective. In your discussion, give at least one example of how this impact is manifested in our society.

In: Nursing

identify and briefly discuss the economic impact of drug use and abuse in the USA from...

identify and briefly discuss the economic impact of drug use and abuse in the USA from a sociocultural perspective.. In your discussion, give at least one example of how this impact is manifested in our society.

In: Nursing

List the main members of the set of techniques known as the Seven Tools of Total...

List the main members of the set of techniques known as the Seven Tools of Total Quality Management (TQM). Then, mention two out of this list which are considered key techniques for defining processes and identifying sources of variation. At which stage in a CQI project life-cycle are these two key techniques needed the most?

In: Nursing

1- Describe Health Disparities between men and women, provide examples. 2- What are common health related...

1- Describe Health Disparities between men and women, provide examples.

2- What are common health related issues for men and women and how can the community nurse help eliminate the disparities.

3- What are new born and infant recommendations regarding safety and what level of prevention will the nurse be implementing?

4- Describe and explain the Affordable Care Act of 2010.

5- What are some of the Adolescents health issues and how can they be prevented?

In: Nursing

1- Describe Health Disparities between men and women, provide examples. 2- What are common health related...

1- Describe Health Disparities between men and women, provide examples.

2- What are common health related issues for men and women and how can the community nurse help eliminate the disparities.

3- What are new born and infant recommendations regarding safety and what level of prevention will the nurse be implementing?

4- Describe and explain the Affordable Care Act of 2010.

5- What are some of the Adolescents health issues and how can they be prevented?

In: Nursing

4. There are 3 common group models through which grieving individuals are served. Explain each one,...

4. There are 3 common group models through which grieving individuals are served. Explain each one, and then discuss which one would be best suited for you if you were experiencing some type of loss that you needed professional help to get through.

In: Nursing