List the medical nursing assessments, interventions, and treatment…List the medical nursing assessments, interventions, and treatment…

Question Answered step-by-step List the medical nursing assessments, interventions, and treatment… List the medical nursing assessments, interventions, and treatment options for hyperemesis, intrauterine growth restriction, and hypertension.Diagram the key anatomic and physiological changes that occur with each body system during pregnancy. Case Overview:Bess Gaskill is a multiparous woman with spontaneous rupture of membranes at 39 weeks gestation. She is being induced using Pitocin and is currently dilated to 9cm, 100% effaced and +1 station. She states she feels like she needs to push when having contractions. Previous visits First prenatal visit today. Client presents with spouse. States she has experienced a little nausea. Reviewed lab results with client. Reviewed concerns regarding advanced maternal age and risk factors associated with pregnancy at age 37. Reviewed need for amniocentesis versus blood testing and nuchal translucency. Client agrees to amniocentesis at 15 weeks. Will schedule next appointment for that time frame. Fundal height 10cm, doppler FHT’s 160. Client denies bleeding or cramping. Reviewed discomforts of pregnancy and ways to reduce discomforts. Admission assessment “I’m here for my appointment and amniocentesis”. “I’m a little nervous about the procedure, I hope it goes okay”. DocuCare Activity/Assignment Prep: Review the Clinical Decision Support Tool (green Lippincott Advisor links) provided throughout your patient’s chart:Labor and BirthAdmissionBreathing Techniques during LaborLabor, Care DuringIV Catheter insertionNon-stress TestDocumentationFetal Monitoring, ExternalAssessment, General SurveyPlacenta ExaminationCarboprostMethylergonovineMisoprostolOxytocinO’Meara, A. Bess Gaskill. Maternity, newborn, and women’s health nursing: A case-based approach. Philadelphia, PA: Wolters Kluwer.Review chart including Patient Information, Maternity, Notes, Assessments, Diagnostics, Vital Signs, and OrdersActivities/Assignments:Part One: Clinical Judgment Activity   After reviewing Mrs. Gaskill’s chart, identify the relevant data related to the patient situation. Analyze the data, ask yourself these questions: What do you notice? (Recognizing Cues/Assessing)What does it make you think? (Analyzing Cues/Diagnosing)What do you think should be done? (Prioritize Hypotheses & Generate Solutions/Planning)What additional information or orders do you need? (Generate Solutions/Planning) Assignment 1.1:Document the answers to the questions in the Notes section > Nursing Note-Progress Note Part Two:  Clinical Judgment Activity  Assignment 2.1:Using the fetal monitoring strip below and the additional information, enter data into Mrs. Gaskill’s electronic health record utilizing the Maternity tab and subcategory Labor Vital Signs.  Maternity: Labor Vital Signs: The patient is side-lying, current dilation is 10cm, 100% effaced, +1 station. External uterine and fetal monitors are in place. Contractions strong to palpation with soft resting tone. Patient remains on 9mu/min Pitocin IV. Patient states she feels the urge to push. Vital Signs: Temp 99.0 oral, HR 90, RR 24, BP – 130/82, Sats 99% on room air  Part Three:  Clinical Judgment Activity  Patient Situation Update:You have Mrs. Gaskill “trial” pushing with the next 3 contractions. She pushes the fetus from a +1 station to +3, and states she feels a burning sensation in her perineum. The perineum is bulging slightly, and you observe a 5cm diameter circle of fetal head. You alert the provider that birth is imminent. Assignment 3.1:Use the data above and your knowledge of the second stage of labor, create a nursing note related to calling the healthcare provider to come for delivery and steps taken to prepare for the impending vaginal delivery. Place the data in the note section of the chart. Use “Nursing Note – Alert Provider”. Provide all the data you can to create a complete note related to the patient situation occurring.  Part Four:  Clinical Judgment Activity  The physician arrives within minutes of calling. Mrs. Gaskill continues to push effectively and 15 minutes after beginning pushing, she has a spontaneous vaginal delivery of a male fetus. The baby weighs 8lbs 5oz (3900g), length is 54cm, head circumference is 34.2cm. His Apgar’s are 9 at 1 minute and 9 at 5 minutes. There were no complications with the delivery, but the pregnancy was complicated by a placental abruption.  Mrs. Gaskill delivered 7 hours and 40 minutes after being admitted. Cord blood was collected and sent to the lab; results are pending. The placenta was intact and delivered spontaneously 15 minutes after the birth. The cord insertion was in the center of the placenta. Assignment 4.1:Use the data above to document the delivery. Use the “Maternity – Delivery” tab to document all components of a vaginal delivery. Debriefing Questions: Upon completing the above in the chart, upload the answers to Canvas. How did you feel while completing this assignment?What went well during this activity? What did you find challenging?What data in Mrs. Gaskill’s health record was relevant and/or concerning?What risk factors related to post-partum hemorrhage are present in Mrs. Gaskill’s health record. How would you prepare for this potential complication?What fetal heart rate pattern was evident on the monitoring strip? What nursing interventions are associated with this fetal heart rate pattern?What actions could you take if you encountered this fetal heart rate pattern and the patient was 5cm? Health Science Science Nursing NURSING 221 Share QuestionEmailCopy link Comments (0)