Obstetrics and Nurse free essay sample

At 0600 Jennie is brought to the Labor and Delivery triage territory by her sister. The customer gripes of a beating cerebral pain throughout the previous 12 hours unrelieved by acetaminophen (Tylenol), swollen hands and face for 2 days, and epigastric torment portrayed as awful indigestion. Her sister tells the medical caretaker, I felt like that when I had toxemia during my pregnancy. Affirmation evaluation by the medical caretaker uncovers: todays weight 182 pounds, T 99.1â ° F, P 76, R 22, BP 138/88, 4+ pitting edema, and 3+ protein in the pee. Pulse is standard, and lung sounds are clear. Profound ligament reflexes (DTRs) are 3+ biceps and triceps and 4+ patellar with 1 beat of lower leg clonus. The attendant applies the outside fetal screen, which shows a pattern fetal pulse of 130, missing changeability, positive for increasing velocities, no decelerations, and no compressions. The medical caretaker additionally plays out a vaginal assessment and finds that the cervix is 1 cm enlarged and half destroyed, with the fetal head at a - 2 station. We will compose a custom exposition test on Obstetrics and Nurse or then again any comparative theme explicitly for you Don't WasteYour Time Recruit WRITER Just 13.90/page 1. In auditing Jennies history, the medical caretaker is right in inferring that Jennie is in risk of building up a hypertensive issue on account of her age (15). Which different factor(s) add to Jennies danger of creating preeclampsia? (Select all that apply.) A) Molar pregnancy and history of preeclampsia in past pregnancy. B) Familial history. C) History of beating cerebral pain, low financial status. D) Preexisting clinical or hereditary condition, similar to Factor V Leiden. E) Nulliparity 2. To precisely evaluate this customers condition, what data from the pre-birth record is generally significant for the medical attendant to acquire? A) Pattern and number of pre-birth visits. B) Prenatal pulse readings. C) Prepregnancy weight. D) Jennies Rh factor. Pathophysiology of Preeclampsia There is no conclusive reason for preeclampsia, yet the pathophysiology isâ distinct. The principle pathogenic factor is poor perfusion because of arteriolar vasospasm. Capacity in organs, for example, the placenta, liver, mind, and kidneys can be discouraged as much as 40 to 60%. As liquid moves out of the intravascular compartment, an abatement in plasma volume and ensuing increment in hematocrit is seen. The edema of preeclampsia is summed up. For all intents and purposes all organ frameworks are influenced by this sickness, and the mother and embryo endure expanding hazard as the ailment advances. Preeclampsia creates following 20 weeks incubation in a formerly normotensive lady. Raised circulatory strain is as often as possible the principal indication of preeclampsia. The customer likewise creates proteinuria. While not, at this point thought about a symptomatic estimation of preeclampsia, summed up edema of the face, hands, and mid-region that isn't receptive to 12 hours of bedrest is regularly present. Preeclampsia advances along a continuum from gentle to extreme preeclampsia, HELLP condition, or eclampsia. A customer may present to the work unit anyplace along that continuum. 3. What is the pathophysiology answerable for Jennies grievance of a beating cerebral pain and the raised DTRs? A) Cerebral edema. B) Increased perfusion to the cerebrum. C) Severe nervousness. D) Retinal arteriolar fits. Jennies sister is extremely worried about the growing (edema) in her sisters face and hands since it is by all accounts compounding quickly. She inquires as to whether the social insurance supplier will endorse a portion of those water pills (diuretics) to help dispose of the overabundance liquid. 4. Which reaction by the attendant is right? A) That is a generally excellent thought. I will transfer it to the human services supplier when I call. B) Im sorry, however it isn't the familys spot to make recommendations about clinical treatment. C) Let me disclose to you about the impact of diuretics on pregnancy. D) Have you by any possibility given your sister water pills that have a place with another person? Admission to the Labor and Delivery Unit At 0630 the medical caretaker calls to answer to the medicinal services supplier, who recommends the accompanying: confess to work and conveyance, bedrest with restroom benefits (BRP), IV D5LR at 125 ml/hr, oxytocin (Pitocin) 2 mu/min, CBC with platelets, thickening investigations, liver catalysts, science board, 24-hour pee assortment for protein and uric corrosive, ice chips just by mouth, nonstress test, hourly essential signs, and DTRs. 5. After the medical attendant builds up IV situation, she gathers a sack of D5LR for the oxytocin (Pitocin), which is accessible in 20 units in 1000 cc D5LR. The request from the human services supplier is oxytocin (Pitocin) 2 mu/min to enlarge work. Figure the accompanying dribble rate for the oxytocin (Pitocin). (Enter the numerical worth as it were. In the case of adjusting is required, round to the entire number.) 6. While the medical attendant is anticipating the lab results, which nursing mediation has the most elevated need? A) Teach Jennie the method of reasoning for bedrest. B) Monitor Jennie for indications of lack of hydration. C) Educate the customer about dietary limitations. D) Observe Jennie for CNS changes. 7. Which procedure should the attendant use while assessing Jennies circulatory strain while she is on bedrest? A) Have Jennie lay prostrate and take the pulse on the left arm. B) Have Jennie lie in a horizontal position and take the circulatory strain on the reliant arm. C) Have the customer sit in a seat at the bedside, and take the circulatory strain with her left arm at midsection level. D) Have Jennie stand quickly and take the circulatory strain on the correct arm. The medical caretaker plays out a nonstress test to assess fetal prosperity. 8. When playing out a nonstress test (NST), the medical attendant will survey for which parameters? An) Accelerations of the fetal pulse in light of fetal development. B) Late decelerations of the fetal pulse because of fetal development. C) Accelerations of the fetal pulse in light of uterine compressions. D) Late decelerations of the fetal pulse because of uterine constrictions. HELLP Syndrome At 0800, physical evaluation and labs uncover the accompanying: the customer is as yet grumbling of a cerebral pain however the epigastric torment has slightlyâ decreased. While the customer is resting in a left horizontal position, the essential signs are BP 146/94, P 75, R 18. Hyperreflexia proceeds with one beat of clonus. The gauge fetal pulse is 140 with moderate fluctuation and no decelerations. Since consummation of a receptive nonstress test, no further increasing velocities have happened. Lab results include: hemoglobin 13.1 g/dl, hematocrit 40.5 g/dl, platelets 120,000 mm3, aspartate aminotransferase (AST) marginally raised, alanine aminotransferase (ALT) typical for pregnancy, 0 burr cells on slide, coagulating reads typical for pregnancy. The medicinal services supplier determined Jennie to have preeclampsia instead of HELLP condition, a variation of extreme preeclampsia. 9. In the event that Jennie had HELLP condition, which lab results would the medical attendant anticipate that her should display? An) Elevated hemoglobin and hematocrit (HH) without burr cells, raised liver chemicals, platelet tally 150,000 mm3. B) Decreased hemoglobin and hematocrit (HH) with burr cells, raised liver catalysts, platelet check