Question

1.In an effort to practice culturally competent nursing care, the nurse will need to assess the desired rituals and cultural diversity of each patient. What information should be included in the assessment of cultural needs of a pregnant woman?

2.Identify the steps involved in the assessment and management of bleeding during late pregnancy.

Answer 1

• A women’s experiences of health and illness. Religious faith and a spiritual lifestyle are correlated with a higher quality of life emotionally, mentally, and physically. An assessment of the importance of these dimensions may

include the following questions:

1. Do her spiritual beliefs have a strong impact on how she defines life experience, health, illness, and death?

2. How meaningful is her faith?

3. What are her sources of strength and coping?

How essential it is that cultural competency be characterized by sensitivity to the multiple dimensions of women’s lives

• Cultural competence is a dynamic process that occurs over time. It begins with an exploration of one’s own cultural beliefs and practices, as well as biases, and stereotypical attitudes in order to gain a beginning understanding of others. It can be richly rewarding to gain a historical perspective of one's cultural heritage by interviewing parents and grandparents. Personal writing, such as recording one’s own life history, and journaling may be effective strategies fostering introspection and self-assessment.

Nursing intervention for bleeding during late pregnancy. :

• Assess maternal physiological circulatory status and blood volume.
• Auscultate and report FHR; note bradycardia or tachycardia. Note change in hypoactivity or hyperactivity.
• Note the expected date of birth (EDB) and fundal height.
• Monitor and record maternal blood loss and uterine contractions.
• Institute strict bed rest in lateral position.
• Obtain vaginal specimen for alkali denaturation test (APT test), or use Kleihauer-Betke test to determine maternal serum, vaginal blood, or products of gastric lavage.
• Carry out/repeat NST, as indicated.
• Assist with ultrasonography and amniocentesis. Explain procedures.
• Replace maternal fluid/blood losses.
• Administer supplemental oxygen to the client.
• Prepare client for appropriate surgical intervention as indicated.