You are the charge nurse working in labor and delivery at a local hospital. D.H. comes to the unit having contractions and feeling somewhat uncomfortable. You take her to the intake room to provide privacy, have her change into a gown, and ask her three initial questions to determine your next course of action, that is, whether to do a vaginal exam or to continue asking her more questions.
1. What three initial questions will you ask, and why?
What brings you to the hospital today? The nurse should ask open-ended questions to allow the patient to
Articulate her concerns. The priority is to establish a therapeutic relationship with the patient. (Durham & Chapman, 2014, p. 206)
How many weeks pregnant? The nurse should determine the gestational
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is in the first stage of labor so it is important for the nurse to monitor intake and output; generally diet is limited oral intake to clear liquids. Emptying the bowel and bladder is important for more pelvic room, decreasing pressure and injury to urethra and bowel, and comforting the mother. The nurse should encourage walking and frequent position changes to assist with labor progression, fetal decent, and pain management. The nurse should assess for pain and treat with pharmacological and non-pharmacological strategies. The nurse should provide a safe environment and emotional and physically support to the mother and family. Also the nurse must document the admission and progression of labor. (Durham & Chapman, 2014, p. …show more content…
Put these actions in order of priority : 2 a. Discontinue the oxytocin infusion. 1 b. Turn D.H. onto her left side and elevate her legs. 3 c. Increase the rate of the maintenance IV fluids. 4 d. Administer oxygen at 8-10 L1min by facemask.
According to Durham & Chapman, (2014), the appropriate nursing actions are aligned with the actions above in the order of B, A, C, D. It is important to change the maternal position, discontinue the oxytocin, assess hydration by giving an IV bolus, consider fetal scalp stimulation or VAS, administer O2 at 10L/min via non-rebreather face mask, consider invasive monitoring with fetal spiral electrode (FSE), support the woman and family, notify physician or midwife, plan for delivery and care of the neonate. Interventions are directed at the causes of late decelerations. (p. 251– 252)
10. Decelerations occur in an early, variable, or late pattern. What is the significance of these patterns? State what the nurse should do for each type.
The primary textbook for the course, Durham & Chapman, 2014, clearly discusses decelerations and the nursing actions for each one, they are as follows:
Early deceleration – are visually apparent, usually symmetrical with a gradual decrease and return of
At the multidisciplinary meeting, the nurse will collect and assess the information provided by the other disciplines and family members stating that the patient is not at her prior level of functioning and then analyze the information to develop a diagnosis of deconditioning. Next, the nurse identifies outcomes for the patient to get stronger, achieve prior level of function, have activities of daily living (ADL’s) met in a safe environment by planning for home health, equipment, and 24/7 supervision through family or placement in a facility. This will be implemented by coordinating delivery of a walker and a 3 in 1 chair prior to discharge to daughter’s home with the home health agency nurse, physical therapist, and aide scheduled to start that day. In a week, the nurse evaluates that outcomes are being met by following up with patient, daughter, and home health agency evaluating that the patient is getting stronger, ADL’s are being met, and will soon be able to return to living independently. To achieve these standards of practice, every nurse should be aware of her own nurse practice act to ensure to be functioning with in the laws of the nurse’s state and to ensure the best outcomes and safety of the patients. In closing, it is every nurses duty to be the best nurse they are capable of being by looking at the scope of nursing practice which gives us the framework to achieve
... this type of knowledge the nurse understood that her patient has a lack of social support and probably depressed. She encouraged Miss. Z to have a positive attitude to her life and current illness. The patient’s knowledge allowed me to understand that the client is having a difficult period in her life. She definitely needs a social worker and a support group to get through this challenging period. In the future I would like to observe more closely how this patient will respond to social worker’s help.
As Nurse Nacey Nicity began to her initial assessment on her patient, Nurse Jody McMean began to question her every mood not only in front of the other staff but also in the patient’s room. Due to the inappropriate comments made by the experienced nurse the family requested for a new nurse and for Nurse Nacey Nicity to drop their case. After Nurse Nacey Nicity handed-off, the patient she began to cry and run off the unit without speaking to anyone.
...ck to Basics: Hourly Nursing Rounds to Decrease Patient Falls and Call Light Usage and Increase Patient Satisfaction. Retrieved from http://stti.confex.com/stti/congrs08/techprogram/paper_37872.htm
...e baby still seems to have too much fluid in his or hers mouth or nose, the nurse may do further suctioning at this time. At one and five minutes after birth, an Apgar assessment will be done to evaluate the baby's heart rate, breathing, muscle tone, reflex response, and color. If the baby is doing well, the mother and the baby will not be separated. The nurse will come in from time to time to change diapers, check the babies temperature, and perform other tasks while the baby spends time with his or her mother and father (B. C. Board).
There are several levels of prioritization that nurses can use to organize their time (Lake, Moss & Duke, 2009). The first is the ABC plus V, which includes such problems as airway, cardiac or circulation, vital signs and breathing. Activities of the second level of prioritization are the ones that are immediately subsequent to those in the first level. These include untreated medical issues, mental status, acute elimination, risks, and abnormal lab results. The third level is composed of those health issues that are not included in the first two levels, including education, coping, and rest.
Nursing/Academic Edition. Web. The Web. The Web. 01 Apr 2014.
...o find a balance between interventional and non-interventional birth. With this being said, I also understand that there are strict policies and protocols set in place, which I must abide to as a healthcare provider, in any birth setting. Unfortunately, these guidelines can be abused. Christiane Northrup, MD, a well recognized and respected obstetrician-gynecologist has gone as far as to tell her own daughters that they should not give birth in a hospital setting, with the safest place being home (Block, 2007, p. xxiii). Although I am not entirely against hospital births, I am a firm believe that normal, healthy pregnancies should be fully permissible to all midwives. However, high-risk pregnancies and births must remain the responsibility of skilled obstetricians. My heart’s desire is to do what is ultimately in the best interest of the mother, and her unborn child.
1. What is the difference between a. and a. Which K, S, and A pertain to the care you provided to the patient you have chosen? Why do you need to be a member? K- Describe the limits and boundaries of therapeutic patient-centered care. S- Assess levels of physical and emotional comfort.
The patient is more likely to focus all their questions and concerns to the nurse. When then the
For one woman, this vision of childbirth is not the norm. Ana Rhodes is a midwife, and she is one of the only birth attendants available to...
Therefore, instruction for nursing process logs is mainly done by instructors, while charge nurses are directly responsible for instruction in nursing techniques carried out on patients, and the matter is discussed by both sides before training begins. For this case, instructors went on-site each morning and at necessary times throughout the day, making adjustments to training instruction in consultation with the charge nurse and giving training instruction. Instructors planned interim consultations with the charge nurse, confirming the direction of the nursing plan. In addition, instructors kept track of what the trainee needed to know in terms of the nursing care process by judging the trainee’s response to questions and the content of nursing logs. When one trainee was worrying about how to tailor a massage method for a patient, the trainee and the instructor took turns giving massages to the patient, prompting the trainee to think about what technique would be most
Each of these concepts applies to the nursing process and can be theorized about extensively due to the ability to apply this theory and the concepts to a wide variety of patient
As much as working is very demanding especially as a nurse so is studying also. There are so many challenges which are involved in working and studying at the same time, some of which are: Goal, Finances, Stress, Time Management and Socialization. These challenges have both positive and negative effects on working and studying. As a matter of fact, it takes one determination and commitment to be able to combine the two at the same time and still be able to achieve ones aim.
Although childbirth appears to be a calm and unforgettable moment for mothers and family members, there can be severe complications that can affect not only the mother, but also the delivery and the child; on the contrary, the process may also run smoothly without any