1. *Vrite a nursing care plan for a patient you are taking care of in the labor room who delivers a newborn, you are the nurse who is assisting the DR. Include the apgar score and the rationale
•AtpQfor each apgar score and your description from delivery to transfer of mother and baby to postpartum floor/nursery and discharge home. Include assessment of mother in the postpartum unit. Assessment of the newborn to include all reflexes.
2.
You are working on labor and delivery and a laboring gravida 2 para 1 patient is due for a vaginal exam. As you are about to assess the patient, you notice the cord has prolapsed. Write a nursing care plan for this scenario.
3. You are monitoring a patient after admission with a diagnosis of pre- eclampsia. As you are talking with the patient, the patient begins to experience an eclampsia event. Write a nursing care plan in this scenario. bwp-cg•c.nSOY7 ‘
4. You are assigned to a laboring patient who is receiving oxytocin infusion to induce labor. She begins to have hypertonic contractions as displayed on the external fetal monitor connected to her abdomen. In addition the fetal monitor shows a nonreassuring fetal heart tone.
5. You are assigned to a postpartum patient and on assessment you detect a full bladder and who is also experiencing hemorrhage and shock.
6. You are a nurse taking a walk in the park, while doing so, You notice a child suddenly having a nosebleed. Write a care plan for this child.
7. You are a nurse on the pediatric floor. One of your patients has type 1 diabetes and experiences a hypoglycemia mia attack. On entering the room what would you do? Write a care plan for this patient. [tart, • -30
8. You are taking care of an infant who is choking, write a care plan .
9. You are the nurse on the pediatric floor who is taking care of a child who is having a
hypercyanotic spell.
10. You are working in the ER and a child arrives who ingested cleaning liquid.
11. you are assigned a child with fractures in various parts of his body, The old fractures are now healed, however today he is showing new fractures of the right femur.
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This assignment competes the simulation for obstetrics and Pediatrics.
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Expert Solution Preview
Introduction:
As a medical professor responsible for designing assignments and evaluating student performance, I have prepared answers to various nursing care plan scenarios in obstetrics and pediatrics. In this assignment, I have included care plans for scenarios such as delivery of newborns, pre-eclampsia, hypertonic contractions, bleeding and shock, pediatric emergencies such as nosebleeds, diabetes, choking, hypercyanotic spells, and ingestion of cleaning liquid. Each care plan includes the necessary steps to care for the patient, assessment, and transfer to the postpartum or pediatric floor, as well as discharge home.
1. Nursing Care Plan for Delivery of Newborn:
Assessment: Apgar score of the newborn to be taken at 1 minute and 5 minutes. Provide warmth and suction the airway.
Plan: Transfer mother and baby to postpartum floor/nursery after observation for 2 hours. Perform all newborn reflex assessments, such as rooting, sucking, and grasping. Conduct screening tests such as hearing and metabolic screening. Encourage skin-to-skin contact between mother and baby. Educate mother on basic newborn care, such as feeding and bathing.
2. Nursing Care Plan for Prolapsed Cord:
Assessment: Note the time of prolapse and place the patient in Trendelenburg or knee-chest position to relieve pressure on the cord.
Plan: Administer oxygen to the mother and monitor fetal heart rate. Place a sterile gloved hand in the vagina to relieve pressure on the cord. Monitor the progression of labor and ensure the patient is prepared for an emergency cesarean section. Administer medications to halt labor if necessary.
3. Nursing Care Plan for Eclampsia Event:
Assessment: Observe changes in mental status and administer oxygen to prevent hypoxia.
Plan: Administer magnesium sulfate to prevent seizures. Administer antihypertensive medications to lower blood pressure. Prepare for delivery if the patient is at term or plan for preterm delivery if necessary. Monitor fetal heart rate and perform a fetal non-stress test.
4. Nursing Care Plan for Hypertonic Contractions and Non-reassuring Fetal Heart Tone:
Assessment: Assess maternal cervix for dilation and effacement. Monitor fetus for positioning and assess amniotic fluid levels.
Plan: Discontinue the oxytocin infusion if necessary. Administer medication to suppress uterine contractions if required. Monitor the fetal heart rate continuously and consider fetal scalp stimulation for further evaluation. Prepare for an emergency cesarean section if necessary.
5. Nursing Care Plan for Full Bladder, Hemorrhage, and Shock:
Assessment: Obtain vital signs, including blood pressure, heart rate, respiratory rate, and pulse oximetry. Measure blood loss and assess the severity of the hemorrhage.
Plan: Remove the patient’s full bladder via catheterization. Administer medications to control bleeding, such as oxytocin or methylergonovine. Administer fluids and blood products as necessary to stabilize the patient’s blood pressure. Monitor the patient’s hemoglobin levels and coagulation status.
6. Nursing Care Plan for Nosebleed:
Assessment: Assess the location, duration, and amount of the nosebleed. Check for signs of hypovolemia due to blood loss and monitor vital signs.
Plan: Apply pressure to the nose with a cloth or cotton balls. Apply ice packs to the bridge of the nose. Administer medication to constrict blood vessels if necessary. Monitor the patient’s hemoglobin levels and coagulation status. Educate the patient and family on prevention and management of nosebleeds.
7. Nursing Care Plan for Hypoglycemia in a Patient with Type 1 Diabetes:
Assessment: Obtain blood glucose level, vital signs, and mental status. Check for signs of hypovolemia due to insulin overdose.
Plan: Administer glucose or glucagon to raise blood glucose levels. Monitor the patient’s blood glucose levels frequently. Provide ongoing education on managing diabetes and preventing hypoglycemic events. Observe the patient for signs of hypoglycemia coma or seizures.
8. Nursing Care Plan for Choking Infant:
Assessment: Check for airway obstruction and assess the level of consciousness.
Plan: Perform the Heimlich maneuver or chest thrusts to remove airway obstruction. Administer oxygen and monitor vital signs. Provide encouragement to the parent or caregiver and educate on prevention of choking hazards.
9. Nursing Care Plan for Hypercyanotic Spell:
Assessment: Assess the child’s respiratory status, oxygen saturation levels, and level of consciousness.
Plan: Administer oxygen to raise oxygen levels in the blood. Administer medications to reduce the workload on the heart, such as morphine or propranolol. Prepare for diagnostic tests such as echocardiography to identify underlying heart defects. Educate the parents or caregivers on identifying triggers and signs of hypercyanotic spells.
10. Nursing Care Plan for Ingestion of Cleaning Liquid:
Assessment: Obtain a history of the type and amount of cleaning fluid ingested. Monitor vital signs and level of consciousness.
Plan: Administer activated charcoal to absorb the toxin. Provide supportive care such as airway management and oxygen administration. Administer an antidote or specific treatment as necessary. Educate the patient and family on the prevention of accidental ingestion.
11. Nursing Care Plan for Fractures in a Child:
Assessment: Assess the child’s pain level, range of motion, and functional abilities.
Plan: Administer pain medication and immobilize the fracture site to prevent further injury. Monitor for signs of infection or compartment syndrome. Consult with a specialist for further evaluation and management of the fractures. Provide ongoing education on safety and injury prevention.
