Question

Fatime Sanogo is a 23-year-old primiparous female from Mali in her first hour after vaginal delivery. The patient was admitted yesterday at 0600 hours for oxytocin induction of labor secondary to postdates (41 4/7 weeks). She declined all pain medication during labor.

Following a prolonged second stage, she delivered a vigorous female infant at 0605 hours with Apgar scores of 9 and 9 and weight of 4,082 g (9 lb 0 oz). The patient contracted a second-degree perineal laceration during delivery; this has been repaired.

Placenta was delivered manually at 0635 hours via Dr. Schultz. Bleeding was controlled by fundal massage and infusion of remaining oxytocin induction bag, which is still running at 20 mL/hr (20 mU/min); approximately 100 mL left in the bag.

The patient was just up to the bathroom and couldn't void. She is now dozing, and the father of the baby is at the bedside, holding the baby and sending text messages from the phone. Fatime does not speak English fluently, as she has only been in the country for 7 months. You enter the room to assume care of the patient and to perform the second of four assessments every 15 minutes.

DIAGNOSIS: Oxytocin induction of labor secondary to postdates (41 4/7 weeks)

WHAT ARE THE:

Alterations in Health (Diagnosis):

Pathophysiology Related to Client Problem:

Health Promotion and Disease Prevention:

Risk Factors:

Expected Findings:

Laboratory Tests:

Diagnostic Procedures:

Nursing Care:

Therapeutic Procedures:

Medications:

Client Education:

Interprofessional Care:

Safety Considerations:

Complications:

Answer 1

*ALTERATIONS IN HEALTH- _POST PARTUM URINARY RETENTION- IS INABILITY TO VOID WITH A PAINFUL, PALPABLE BLADDER DURING POST PARTUM PERIOD. *PATHOPHYSIOLOGY _POST PARTUM URINARY RETENTION CAUSED BY DAMAGE OF DETRUSOR MUSCLES AND PARASYMPATHETIC NERVES OF THE BLADDER. _ INCREASED LEVELS OF PROGESTERONE LEVEL DURING THE TIME OF PREGNANCY AND FIRST PERIOD OF PUEPERIUM CAUSE BLADDER ATONY CAUSE DETRUSOR MUSCLES DAMAGE. _ TISSUE OEDEMA AROUND UROGENITAL AREA LEADS TO OBSTRUCTION IN URINE FLOW. *HEALTH PROMOTION AND DISEASE PREVENTION _ TIMED VOIDING _ TAKE MEDICATION AS PRESCRIBED _ DO PELVIC FLOOR EXERCISES _ DIETARY AND LIFESTYLE MODIFICATIONS _ INCREASED FLUID INTAKE _ URINARY CATHETERIZATION IS DONE TO RELIEVE PAIN DUE TO FULLNESS OF BLADDER. * RISK FACTORS - PROLONGED SECOND STAGE OF LABOUR _ EPISIOTOMY, PERINEAL LACERATION _ MACROSOMIC BIRTH _ PRIMARY PARITY _ FIRST VAGINAL DELIVERY