Question

Q1:. Discuss the immediate newborn care and management ?

Q2: Describe three nursing diagnosis in PES format for a patient who delivered now?

Q3:Discuss the changes in circulation in the fetus immediately after birth ?

Q4: Discuss the stages and phases of labor with its management in each stage ?

Q5:Discuss the types of molar pregnancy, signs and treatment. (medical, surgical and nursing) ?

Q6:Discuss the changes and management during menopause ?

Q7:Discuss the nursing management of a patient with bleeding and placenta previa ?

Q8:Briefly discuss the role of progesterone in pregnancy ?

Answer 1

QUESTION-1

NEWBORN

Newborn is defined as the period from the birth till 28 th days after the delivery

OBJECTIVES OF IMMEDIATE NEWBORN CARE

-to maintain body temperature

-to maintain airway and circulation

-to prevent from further complications

-to maintain pulmonary and circulatory status

ELEMENTS OF NEWBORN CARE AND ITS MANAGEMENTS

-Temperature regulation

-Maintain airway and circulation

-APGAR SCORING

-Assessment of newborn

-Administration of vitamin k

-Exclusive breast feeding

TEMPERATURE REGULATION

-clamp and cut the umbilical cord

-dry the infant with a dry clean towel and then keep under a radiant warmer

-promote skin-to-skin contact with mother

  -cover the baby with clean dry towel and head and extremities have to cover

close monitoring and temperature have to record

  -maintain warm enviornment

MAINTAIN AIRWAY AND CIRCULATION

-babies should cry immediately after the birth

-suction the secretions the mouth first and nose to prevent aspiration of fluids

-wipe mucus from face,mouth and nose

-keep babies in a comfortable positions

APGAR SCORING

- It is a procedure used to assess the respiratory ,circulatory and neurological status

-Total score is 10

A-activity or muscle tone

P-pulse rate

G-grimace or facial expressions

A-appearance or skin colour

R-respiration

ADMINISTRATION OF VITAMIN K

Vitamin k is a drug or chemical substances used to prevent the bleeding disorders or hemorrhages immediately after the birth of a babies

EXCLUSIVE BREAST FEEDING

   Advantages of exclusive breast feeding

-to maintain temperature levels and warmth

-to get nutrients

-to get immunity power and prevent from infections

-to increase weight gain and maintain hydration status

-to get vitamin A

QUESTION-2

NURSING DIAGNOSIS IN PES FORMAT

P-PROBLEMS

E-ETIOLOGY

S-SIGNS AND SYMPTOMS

1-Fluid volume deficit related to increased blood loss as evidenced by fatigue or weakness

problem-fluid volume deficit

etiology-increased blood loss

signs and symptoms-fatigue or weakness

2-Imapired urinary elimination pattern related to less intake of fluid and birth trauma as evidenced by lower abdominal pain

problems-impaired urinary elimination

etiology-less intake of fluid and birth trauma

signs and symptoms-lower abdominal pain

3-Acute pain related to episiotomy sutures as evidenced by irritability

problems-acute pain

etiology-episiotomy sutures

signs and symptoms-irritability

QUESTION-3

CHANGES IN THE CIRCULATION IN THE FETUS

Steps as follows

-clamping of the umbilical cord

-there is no nutrients and oxygen from the mother

-during the first breathing,lungs are start to expand

-lung expansion may help to drain out fluid from the alveoli

-thus increased blood pressure

-so there is reduce the pulmonary blood pressure

-stimulates the closure of the shunt

-due to the closure of the shunt ,there is an increased pressure in the left atrium of the heart

-and decreased pressure in the right atrium

-the pressure changes in the heart chamber may stimulates the foraman ovale to close

QUESTION-4

LABOUR

  

It is defined as the process of expelling out of the products of conception

STAGES OF LABOUR

There are FOUR stages

FIRST STAGES OF LABOUR

Starts from the beggining of true labour pain and ends with the complete dilatation of the cervix

-management includes;

-assessment of frequency of uterine contraction

-changes in the cervical positions,fetal station and positions

-monitoring of fetal heart rates

SECOND STAGES OF LABOUR

Starts from the coplete dialatation of the cervix and ends with the delivery of the newborn baby

-management includes;

-continous monitoring of fetal heart rates

-positioning of the mother

-the process of mechanism of labour

THIRD STAGES OF LABOUR

Starts from the birh of the baby and ends with the delivery of the placents

-management includes;

-management of post partum bleeding

-administarion of intravenous fluids

-control pain

FOURTH STAGES OF LABOUR

Starts from the delivery of the placenta and ends with 1-to 4 hours after the delivery of the placenta

-management include .

-pain control

-breast feeding

-assess involution of the uterus

PHASES OF LABOUR

There are FOUR phases

PHASE -1

-the process of cervical softening

PHASE-2

-the process of active preparation of labour

-PHASE-3

-the process of labour and its includes four stages of labour

PHASE-4

-the process of uterine involution ,cervical repairing and breast feeding