Question

Evidence-based Practice and Informatics Integration in Nursing Practice

The patient has been in the U.S. for 7 months now for Africa and knows some of the English languages. The patient is postpartum and her husband just sat there on his phone while his wife is bleeding! Her vital signs are 90/50 temp. 99 F, O2 94%. resp. 24. Her risk factors in Fatime Sanogo's case that could have led to postpartum hemorrhage are A large baby, large 2nd-degree laceration, use of Oxytocin, prolonged labor Think through the scenario with Fatime Sanogo and consider the communication gaps in relation to technology, evidence-based practices that were implemented, and the application of technology and information. There is no specific quantity of words or pages for the assignment; be sure to comprehensively address each component. Steps to decrease bleeding, and preventing shock. Bolusing of fluids as well as contacting the physician for additional medications. If there is large blood loss and the patient is showing signs of shock a rapid response should be called and the patient transferred. The physician's order is to check for bleeding every 4 hours and lochia, Give Butorphanol tartrate 2mg IV PRN for pain. Put her in a Trendelenburg position when checking Assess perineum. Administer bolus of 500ml LR over 30min for low blood pressure. Perform a straight cath if the patient having trouble urinating. Palpate the fundus. Assess bladder status. Give oxytocin 60 units in 500 mL. If pain is over 5 give 5 mg of Morphine IV. Give patient non-rebreather mask 10L.

Temp. greater 99, Heart rate below 50 and over 100, Resp. lower then 12 and higher 24, 02 is below 94%. and heavy bleeding in lochia. Call a physician if condition worsens

List the assessment findings and actions that should or should not have been initiated in the care of Fatime, and using evidence-based practice guidelines and describe reliable sources for locating evidence reports and clinical practice guidelines?

Answer 1

Postpartum condition is the condition after childbirth. Postpartum hemorrhage is the excessive bleeding after childbirth due to loss of uterine muscle tone in uterine muscle or in case of bleeding disorder of mother or placenta falling to come out completely or tearing of the pelvic organs. This may cause very low BP and hypovolemia and death of the mother.

The emergency assessment findings of the patient will be =

- monitor the vital signs of the patient mainly the BP if the client.

- pereneum examination has to be done quickly to detect the causes and location of bleeding. Check for any tear present.

- check the mucus and epithelial layers for any signs of dehydration .

- assess the level of pain by pain scale measurements.

- take history of any blood clotting disorder and detail history of pregnency if possible.

- assess the respiratory and cardiac condition.

Interventions =

- the vital signs monitoring findings are BP = 90/50 mm of Hg, temp. = More than 99°F, respiratory Rate = more than 24 breathes per min., Pulse = below 50 bpm. and more than 100 bpm.

- all the prescribed medications has to administer quickly as direction.

- two IV line or IV cannula has to place.

- Intravenous fluids like LR 500 ml. has to be administer rapidly. Other IVF like as NS or RL can be administered for farther maintainance dose.

- moist Oxygen has to be administered to maintain SpO2 of blood.

- the third stage of labour has to perform very carefully.

- the bleeding has to control by detecting the location of bleeding and providing the suturing on the tears of vagina, cervix.

- the uterus has to massage to bring out the clots. Bimanual compression on the uterus , and manual compression on artery has to apply to spot bleeding.

The reporting should be done by local hospital roule and approved guidelines. In the given setuation the evidence based practice is mandatory as there is a communication barrier in between patient and health care professional and this requires soft skills that improve patient interaction. The reliable source of evidence report and clinical practice guidelines is National Institute of Health research and Dissemination Center , National Institute of Health and care excellence. As the are approved guidelines for reporting evidence based practices.