Please read the following case study details. Then answer the questions below.
Setting
You are a nurse caring for women on the post-partum floor. Kristen was admitted to the floor an hour ago right before change of shift.
Introduction
Kristen gave birth to a 6lb4oz little boy named Sawyer. She had a vaginal delivery complicated by the umbilical chord being wrapped around the infant’s neck. Midline episiotomy was done with extension to deliver the infant quickly due to fetal heart tones and narrow pelvic inlet. 3rd degree laceration. Father of baby not involved at this time and awaiting pending paternity results. Patient’s mother at beside for support. Kristen states she wants to try an breastfeed, but is scared of it hurting.
Chief Complaint
Patient hit call light for nurse, stating “I feel some pressure like I need to push again. Can someone help me up to the bathroom?”
Medical History
Chicken pox as a child. UTD on all immunizations. Tonsils removed 2013.
DOB: 12/31/2005NKDABlood type: O negativeRubella: Non-ImmuneHIV: NegativeHSV: DeniesHepatitis: NegativeHeight: 5’7Weight: 170 lbs. First day of LMP: 6/13/2002
G-1 T-0 P-1 A-0 L-1 G-1 P-1Vaginal Delivery: 35 weeks 2 days APGARS: 1 MIN: 7, 5MIN: 9(1 off for breathing, 2 off for color)
Fundus firm, 1 aboveMild to moderate bleedingNo bowel movements 500 cc’s output post delivery in L&D via straight cath. Patient has yet to ambulate to bathroom to void. Nipples sore per patient, no cracks or fissures noted
Questions
- Based on the chief complaint what do you think is the cause of this vaginal pressure? (Explain the associated risks and nursing interventions)
- Utilizing the BUBBLEEE acronym and the patient information provided, identify additional assessment information and interventions needed for each section.
- Breasts:
- Uterus:
- Bladder:
- Bowels:
- Lochia:
- Episiotomy and perineum:
- Extremities:
- Emotions:
- What patient education is needed for this patient prior to sending her home at discharge? List at least 5 different topics that need to be addressed.
- Add a question: After you have analyzed the content from the discussion board, please add a question to the end of your initial post regarding the reading material for the week.
Please be sure to validate your opinions and ideas with citations and references in APA format.