After reviewing and analyzing each patient scenario, the most challenging patient, is the patient Jasmine, experiencing contractions and increased heartburn in her third trimester. Consequently, requiring priority clinical attention and care.
Braxton Hicks contractions are described as tightening in the abdomen that comes and goes. These contractions do not get closer together, do not increase in how long they last or how often they occur and do not feel stronger over time, like real labor contractions. False labor contractions as it is commonly termed, often come with a change of position and stop with rest("False labor & pregnancy | Cleveland Clinic", 2017).
Even though Braxton Hicks contractions are expected early signs of uterine preparation for labor, some women may experience these type of contractions as a result of physiological triggers including increased physical activity, stress, full bladder, and dehydration. Therefore, a focused assessment would be appropriate to determine the cause of the contractions establish an accurate diagnosis, leading to efficient and evidence-based treatment("False labor & pregnancy | Cleveland Clinic", 2017).
…show more content…
As the Advanced practitioner caring for this patient, I would focus on educating this patient beginning by explaining to the patient their etiology and how to differentiate between "false labor" and real labor contractions.
Moreover, I would encourage jasmine to increase the amount of fluid intake as dehydration has proven to be one of its primary causes. I would recommend her to drink at least 10 to 12 glasses of water, juice, or milk per day to stay well hydrated, which can aid reduce the frequency and intensity of these contractions. Lastly, I would also advise this patient to employ some interventions, to help reduce her discomfort, including trying to have plenty of rest, practice yoga and breathing exercise that can lead to relaxation("False labor & pregnancy | Cleveland Clinic",
2017). Describe what you could have done differently with that patient. While I do not disagree with the suggested treatment, I would also encourage Jasmine to adhere to lifestyle and diet modifications that would prevent and/or relieve her heartburn symptoms. These strategies include to eat smaller meals; to avoid food prior going to bed, and certain types of acidic, spicy foods along abstaning from tobacco and alcohol use. Besides, to avoid gastric contents to flow back into the esophagus; advising the patient to maintain specific postural changes such as sleeping in a more upright position would reduce the associated increased pressure on the lower esophageal sphincter(Neilson, 2014). References Neilson, J. (2014). Interventions for heartburn in pregnancy. Cochrane Database Of Systematic Reviews. http://dx.doi.org/10.1002/14651858.cd007065.pub2. False labor & pregnancy | Cleveland Clinic. (2017). Cleveland Clinic. Retrieved 15 February 2018, from https://my.clevelandclinic.org/health/articles/9686-true-vs-false-labor
Prior to intubation for a surgical procedure, the anesthesiologist administered a single dose of the neuromuscular blocking agent, succinylcholine, to a 23-year-old female to provide muscular relaxation during surgery and to facilitate the insertion of the endotracheal tube. Following this, the inhalation anesthetic was administered and the surgical procedure completed.
We can organize information regarding this case study by using the Four Topics Method beginning with the Medical Indications. Maria, a 20-year-old female, has been involved in a motor vehicle accident. She has a history of Sickle Cell disease and is currently twenty-five weeks pregnant with her first child. Initially Maria presents with somewhat stable vital signs. She displays tachypnea, and complains of severe abdominal cramping as well as weakness, light-headedness and left shoulder pain. She is neurologically intact with lung sounds that are within defined parameters. Maria’s condition changes and she begins to display signs and symptoms of internal bleeding. This is a life threatening condition. The problem is critical and can be reversed with a transfusion and surgery. The goal of transfusion would be to replace blood loss and restore vascular volume and the goal of surgery would be to repair the bleed. If the bleed is corrected in a timely manner and without complication, the probabilities of success are somewhat high. There is no plan in place to account for therapeutic failure. Medical care in this instance could not only save the life of this patient but also that of her unborn child. Further harm to Maria and her baby could be avoided if she would agree to the treatment.
She checks me, and tracks my surges. My surges are not as frequent as earlier so she recommends for me to sit on the birthing ball. I sit up right on the birthing ball, and lean back on Poet for support and those surges are coming now. I tense up, and my midwife's assistant beautifully guides me through each surge, encouraging me to relax instead of tense up with each contraction. After a while of being on the birthing ball, I am guided to the bathroom, and I sit on the toilet for a few of the surges and finally I am ready to get in the tub and begin pushing. I felt like I was never going to meet our baby. I felt like our baby was
Eden, Elizabeth. "HowStuffWorks "Pregnancy Complications in Older Mothers" HowStuffWorks. N.p., 16 Nov. 2006. Web. 11 Apr. 2014.
The Bishop score is a pelvic scoring system developed to make it easier to determine whether a multiparous woman was a suitable candidate for induction of pregnancy. Although the information in the Bishop score was known by many obstetricians for many years, Edward H. bishop is credited because he pulled the pieces together and formed an organized system accompanied by research and statistics to back up his findings. His paper is called the “Pelvic Scoring for Elective Induction”. In this paper, Bishop describes basic minimal requirements that must be met before any patient can be considered for elective induction of labor (1964).
The first stage of labor actually has two phases. The first phase is called early labor. During early labor, you should start to feel something like light cramps. It is also common to feel pressure in your lower back. This is the start of what is called “contracting”.
If birth has been occurring since the beginning of time why do so many women act as if it’s something new? Nowadays, you have women asking for morphine, walking epidurals, and spinal epidurals. Why are so many women deciding that they can’t do a natural childbirth and what are the risks of not having one? Researchers have done studies on epidurals to determine if they cause women to get an increase in c-sections. They have also done studies to determine if getting an epidural to early will increase the chances of getting an epidural.
The mother may has to go through unexpected labor pain during labor, which is pacified by induction
Between five to ten percent of all infants are born more than two weeks before their due date due to several factors that include infections, illness, poor nutrition, or complications during the pregnancy. Fetal monitors are used in the cases of C-sections because there is a much higher risk of detecting the infant’s distress and therefore can go in more quickly to remove the baby from the uterus. When the mother is under general anesthesia, which is rare in the United States, the mother is not aware of any kind of pain or even the birth of her child. When the mother has spinal anesthesia she has no feeling from the waist down. Sometimes, the best indication that the baby is in distress is the mother- an unfamiliar pain occurs or something else could be a sign of problems.
Worldwide, the rate of cesarean section is increasing. According to the CDC, in 2012 the rate of cesarean sections comprised 32.8% of all births in the United States (CDC, 2013). Between 1996-2009 the cesarean section rate has risen 60% in the U.S (CDC, 2013). According to the World Health Organization (WHO), more than 50% of the 137 countries studies had cesarean section rates higher than 15% (WHO, 2010). The current goal of U.S. 2020 Healthy People is to reduce the rate of cesarean section to a target of 23.9%, which is almost 10% lower than the current rate (Healthy People 2020, 2013). According to a study conducted by Gonzales, Tapia, Fort, and Betran (2013), the appropriate percentage of performed cesarean sections is unclear, and is dependent on the circumstances of each individual birth (p. 643). Though often a life-saving procedure when necessary, the risks and complications associated with cesarean delivery are a cause for alarm due to the documented rate increase of this procedure across the globe. Many studies have revealed that cesarean deliveries increase the incidence of maternal hemorrhage and mortality and neonatal respiratory distress when compared to vaginal deliveries. As a result, current research suggests that efforts to reduce the rate of non-medically indicated cesarean sections should be made, and that comprehensive patient education should be provided when considering an elective cesarean delivery over a planned vaginal delivery.
The hospital room holds all the usual scenery: rooms lining featureless walls, carts full of foreign devices and competent looking nurses ready to help whatever the need be. The side rails of the bed smell of plastic. The room is enveloped with the smell of plastic. A large bed protrudes from the wall. It moves from one stage to the next, with the labor, so that when you come to the "bearing" down stage, the stirrups can be put in place. The side rails of the bed provide more comfort than the hand of your coach, during each contraction. The mattress of the bed is truly uncomfortable for a woman in so much pain. The eager faces of your friends and family staring at your half naked body seem to be acceptabl...
Nurse practitioners in primary care will often be presented by a woman having dysfunctional uterine bleeding (DUB). This difficult to diagnose condition can be complex. According to Schuiling & Likis it accounts for one third of all annual gynecologic visits (2013, p. 610). The terms abnormal uterine bleeding and dysfunctional uterine bleeding has fallen out of favor and anovulatory uterine bleeding has become the standardized terminology. Because many clinicians still use it, this paper shall use the terminology of dysfunctional uterine bleeding (DUB).
Pregnancy can be an exciting and sometimes frightening experience for many women. It was a snowy Sunday afternoon, and I was not feeling very well. I remember all week long, every morning I felt nauseated. I was craving odd foods, and foods I normally would not eat together. I was on the phone with my best friend explaining to her how I was feeling. She said “It sounds like you are pregnant.” That thought never even crossed my mind until that moment. Sure enough she was right, I was pregnant for the first time. I was excited to have a baby and never realized how many emotions or complications can take place during a pregnancy. Everybody that I knew that had babies, had such wonderful experiences. Unfortunately, this happy moment became such a monumental, emotional and stressful time in my life. During my pregnancy, I went through many emotional experiences from almost losing my child, to the uncertainty of a birth defect and early delivery.
Nausea and vomiting are especially common during early pregnancy, particularly within the first trimester. Most women experience nausea and vomiting, commonly referred to as “morning sickness”, which is often attributed to the mother’s reaction to the spike in pregnancy hormones. Although feeling ill is considered normal within the first few months of pregnancy, there are instances of nausea and vomiting that continue on to the second and third trimesters and are then considered more severe. When dehydration, electrolyte imbalances, weight loss, acidosis, or even hepatic and renal damage occur as a result of the hyperemesis, it is then determined to be hyperemesis gravidarum.
Child Birth can be a beautiful, yet unimaginable experience any mother and family member can encounter. It is a process of emotional and social involvements that make-up a natural human being. The familiarity of childbirth can play an important role in life for every individual, especially the mothers who are in labor or in delivery. Each moment during labor will become memories for the mothers to share with their grown up child in the future. Childbirth is a breath taking experience that can change someone’s life forever. The process of childbirth does not occur in a blink of an eye; in fact, it is more of a procedure that may take a few steps. Some mothers during labor, experience a severe amount of pain that medication can control and some