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Nursing Care of Women with Complications During Pregnancy: A....
Nursing Care of Women with Complications During Pregnancy:
A. Case Study -
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REAL-WORLD CASE STUD'lIr Tonya Tonya is a 30—year-old patient, pregnant with her first baby. She is in gestational weeI-r 41 and has had no previous complications
during her pregnancy. Tonya arrives in the labor and delivery unit experiencing severe abdominal pain and vaginal bleedingAs the
nurse assists her into bed, Tonya says: "I used cocaine this afternoon. I haven't used drugs my entire pregnancy, but because it was
my birthday and l was overdue, | used the cocaine. I thought the only risk to using drugs was during the first trimester. Did I cause this bleeding? Is my baby in danger?"
- What bleeding complication of late pregnancy is Tonya experiencing?
- What nursing interventions are appropriate for this situation?
- How would the nurse answer Tonya's questions of "Did I cause this bleeding? Is my baby in danger?
B. Describe the main medical interventions for hyperemesis gravidarum and explain why they are helpful for this condition.
C.
1. Explain how the bleeding disorders of pregnancy are connected to the conceptual cornerstone of perfusion.
Image transcription text
CONCEPTUAL CORNERSTONE Perfusion
Concepts integrate thinking and BSSiSt Wi'ii'l transfemng Knowledge from one patient problem to another patient With a similar condition. The concept of perfusion is applicable in this chapter because of the complications of pregnancy that may result in blood
loss. Perfusion is blood circulating through the body and oxygenating the tissues. Impaired central perfusion occurs in conditions
that decrease cardiac output or cause shock. IT adequately oxygenated blood cannot freely travel to all parts of the body, a state of
inadequate tissue perfusion exists. The bleeding disorders of pregnancy all relate to the concept of perfusion. Regardless of the
cause of poor perfusion. whether it is caused by blood loss from a spontaneous abortion, placenta previa, or placental abruption, the
basic nursing care is similar. Immediate nursing interventions include monitoring vital signs, noting capillary refill time, noting
peripheral pulses, inspecting perineal pads, noting the color and amount of blood, and administering IV fluids and blood products as ordered by the health—care provider.
2. Describe observations about how each of the nursing interventions listed at the end of the Conceptual cornerstone "Perfusion" will tell the nurse of the patient's condition if the bleeding is abnormal. Provide an example of specific values if the patient has an EBL of 500 mL or more during a bleeding episode.
D. In placental abruption, explain why the fetal heart tones could be affected by the bleeding and how nurse would determine if the fetus is showing signs of distress. Provide specific range of values and descriptions nurse might observe.
Answer & Explanation
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