Question

(1) Scenario-Baby boy Bardin is 28 hours old and has developed hyperbilirubinemia. His first-time parents have summoned you to their hospital room because they are very concerned about what this diagnosis means and how to treat it.

Question-Discuss treatment for severe hyperbilirubinemia or when phototherapy is not effective, and any follow-up testing that may be needed after treatment.

(2) Scenario-As the nurse educator for a busy Mother Baby Unit, you are required to provide education to all new staff nurses and annual refresher training to all nurses on your unit.

Question- Describe hemorrhagic shock as a complication of postpartum hemorrhage, including physiological changes and compensatory mechanisms, the shock index and parameter, expected assessment findings, and interventions.

(3) Scenario- You are assuming care for Mrs. Jones, a 36-year-old G2 P1 who is status post-primary cesarean section.  The indication for the cesarean section was failure to progress in active labor secondary to Cephalopelvic disproportion.

Question- At discharge Mrs. Jones reports that she is concerned about postpartum depression. Explain two major risk factors for postpartum depression and provide Mrs. Jones two specific education points to decrease her risk for depression.

Answer 1

1)Hyper bilirubinemia is defined as the elevated serum bilirubin level which is associated with jaundice,enlarged lever ,poormuscle tone and so on.If the babys jaundice is not subsided and the test is showing high levels then the treatment is necessary which includes phototherapy or exchange transfusion.Phototherapy is use of light to reduce serum bilirubin levels in the newborn.When the phototherapy is ineffective then go for exchange transfusion.In this method the babys blood is removed via umbilical cord or arms and matching donor with same blood groups blood is replaced,during these procedures the baby is closely monitoredand the babys blood is taken after 2 hourss to check whether the treatment is successful or not.If it is not successful repeat the procedure.

2) Bleeding of 500ml or more after deliveryand the primary cause of maternal mortality that demnads prompt recognition and intervention.The decreased blood volume may result in sudden fall ofCVP and cardiac filling and it may caused decreased cardiac output and arterial pressure.The normal shock index is 0.5 to 0.7 and the shock index (heart rate)i ndicates failure of left ventricular function.It is calculated byshock index divided by systolic blood pressure.Early assessment includeshemorrhage occurs during the first 24 hours after delivery and the late symptoms occurafter the first 24 hours following delivery.Symptoms includes rstlessness,increased pulse rate and so on.The intrventions are massage the fundus for uterine atony,monitor vital signs every 5 to 15 mts.Assess and estimate blood loss and level of consciousness.Adninister fluid and monitor intake output chart.

3)Postpartum depression is also known as baby blues.It is commonly seen after childbirth which may associated with anxiety ,appetite changes.crying,sadness,feeling gult and so on.The two major risk factors include history of depression and stress around child care.Treatment and support provided to mother .If any signs and symptoms of baby blues detected contact the provider and they may recommend antidepressanttreatment or psychotherapy.This helps to resolve the problem.