NR 327 Antepartum/Intrapartum ISBAR

Name

Chamberlain University

NR-327: Maternal-Child Nursing

Prof. Name

Date

NR 327 Antepartum/Intrapartum ISBAR

I. Identification

S. Situation

F. Findings

B. Background

A. Assessment

Labor Status

R. Recommendations

Discharge Planning

• Notify provider if abdominal pain, nausea, vomiting, abnormal swelling, blurry vision, headache, or decreased urine output occurs.
• Strict adherence to new prescriptions, especially hydralazine for high blood pressure.
• Follow-up on clinical visits as scheduled.

Plan of Care

Based on the patient’s history, presenting symptoms, lab values, and medications, the patient should be closely monitored for worsening preeclampsia. Fetal monitoring should continue to assess heart rate patterns and movement. The patient should remain on bed rest with IV fluids administered, and blood pressure should be regularly checked. Continue administering prescribed medications and monitor for side effects.

NR 327 Antepartum/Intrapartum ISBAR

References

American Psychological Association. (2020). Publication manual of the American Psychological Association (7th ed.).

NR 327 Discharge Teaching RUA Outline

Name

Chamberlain University

NR-327: Maternal-Child Nursing

Prof. Name

Date

Introduction to Topic and Reference to One Statistic

Michelle Jones is responsible for discussing the significance of car seat safety in this section. She will highlight the importance of using car seats for child safety, emphasizing the role they play in preventing injuries and saving lives. Furthermore, she will present a visual aid that illustrates statistical data on the number of children whose lives have been saved due to proper car seat safety measures. This approach underscores the critical role car seats play in child passenger safety and highlights how adherence to safety guidelines can prevent fatalities.

Identification of Risk Factors and/or Benefits

Rebecca Cox will address the significance of car seats as vital safety devices for children in vehicles. She will explore both the benefits and potential concerns associated with their use. Car seats are designed to protect children from injury during accidents, reducing the risk of serious harm. However, some concerns have emerged regarding the efficacy and proper use of these seats. Cox will analyze both the advantages and the potential risks, helping parents make informed decisions about car seat usage for their children’s safety.

Referral to Professional and Community-Based Resources

Brianna Williams will provide valuable information on professional and community-based resources related to car seat safety. She will explain that professional sources, such as those from government or internationally recognized organizations, offer critical guidelines and regulations. For instance, the National Highway Traffic Safety Administration (NHTSA) provides comprehensive car seat regulations across the United States. On the other hand, community-based resources, such as the initiative “Buckle Up for Life,” offer support by gathering parents and providing education on car seat safety. Williams will elaborate on how these resources empower parents to keep their children safe in the car.

Health Promotion Recommendations

Tamara Hawkins and Shelby Powers will be responsible for providing evidence-based health promotion recommendations regarding car seat safety. Drawing from scholarly evidence, they will argue why the proper use of car seats is a critical health concern for children traveling in vehicles. They will advocate for parents to strictly follow car seat safety rules and guidelines to prevent injuries and fatalities. Their recommendations will be grounded in research, emphasizing that adhering to safety standards is vital for the well-being of child passengers.

References

Car Seats and Booster Seats. (2018, November 30). Retrieved March 10, 2019, from https://www.nhtsa.gov/equipment/car-seats-and-booster-seats

NR 327 Discharge Teaching RUA Outline

Child Passenger Safety & Car Seat Safety Check. (n.d.). Retrieved March 10, 2019, from https://buckleupforlife.org/

NR 327 Week 1 Reflection

Name

Chamberlain University

NR-327: Maternal-Child Nursing

Prof. Name

Date

Weekly Reflection: Week 1

1. Application of Learning to Other Disease Processes

During the Monday simulation at school, Professor Peralta emphasized the importance of revisiting the basics as we advance further into nursing. This concept is particularly significant as it allows us to integrate previously learned concepts into more complex situations. For instance, I realized that the four mental health concepts—appearance, behavior, cognition, and thoughts—can be effectively applied to maternal and newborn patients. This demonstrates the versatility of core nursing principles across different patient populations.

2. Relevance and Usefulness of the Information

There are three main reasons why this information is relevant and useful:

• Review of Fundamentals: It serves as a reminder to continually revisit the foundational concepts of nursing, which are essential in providing holistic care.
• Comprehensive Assessment: By revisiting the basics, I can perform a more thorough patient assessment rather than a focused one, allowing for a deeper understanding of the patient’s condition.
• Patient Education: This knowledge enables me to educate patients on potential diseases and symptoms, helping them recognize warning signs and promoting preventative care. These aspects all contribute to offering the highest quality of care possible.

3. Challenges in Retaining and Applying Information

As I delve deeper into core nursing courses, I find that the increasing volume of information can be both easier and more challenging to retain. Balancing the fundamentals of nursing and pathophysiology with new material is particularly demanding. This challenge highlights the importance of continually reinforcing foundational knowledge while integrating new learning. In the future, I will use this experience to enhance my ability to recall and apply complex information in clinical settings.

4. Key Concepts from Virtual Clinical Experience

One of the most valuable concepts I learned from my virtual clinical experience was during my Foley catheter check-off with Professor Alvarado. She corrected my technique and provided insights that I can carry into future clinicals and my nursing career. Additionally, she emphasized the importance of assessing allergies to iodine or shellfish, using scenarios to explain the relevance of these allergies in patient care. This understanding can be applied to broader interrelated nursing concepts, particularly when considering patient safety and individualized care.

References

No external sources were used for this reflection, as the information was acquired from Professors Peralta and Alvarado during clinical sessions.

NR 327 Week 1 Reflection

NR 327 Maternal-Child Nursing Covid-19 and Pregnancy

Name

Chamberlain University

NR-327: Maternal-Child Nursing

Prof. Name

Date

COVID-19 and Pregnancy: Navigating the Challenges for Expectant Mothers

The year 2020 will be etched in history as a time when humanity confronted an unparalleled challenge—the worldwide outbreak of a novel coronavirus known as COVID-19. This pandemic has drastically impacted millions globally, reshaping our daily lives. Social gatherings have been restricted, mask-wearing in public has become standard practice, and even a simple cough can elicit concern. However, the ramifications of COVID-19 extend well beyond everyday life, significantly affecting the healthcare sector. Hospitals and healthcare providers are grappling with substantial obstacles, including a surge in patients infected with the virus, shortages of personal protective equipment (PPE), and widespread burnout among healthcare workers.

Within the healthcare context, it is imperative to explore the intersection of COVID-19 and pregnancy. This article seeks to examine how the virus impacts expectant mothers, the developing fetus, and newborns during both the antepartum and intrapartum stages. Additionally, it will discuss preventative measures that pregnant women can adopt to mitigate their risk of contracting the virus.

Understanding COVID-19: Symptoms, Complications, Transmission, and Risk Factors

COVID-19, as a newly identified virus, remains a topic of ongoing research and investigation as new information becomes available. The global emphasis is on developing an effective vaccine, given the rising number of infections and fatalities. While our understanding of the virus is continually evolving, certain aspects have been firmly established, including its symptoms, complications, modes of transmission, and the populations most at risk.

The incubation period for COVID-19 generally varies from two to fourteen days, with an average duration of about five days. However, this period can differ based on age and preexisting health conditions. The most frequently reported symptoms of COVID-19 include cough, fever, fatigue, sputum production, sneezing, headache, hemoptysis, shortness of breath, sore throat, and lymphopenia. Complications associated with the virus can range from acute respiratory distress syndrome and pneumonia to acute cardiac injury, hypoxemia, and, in severe cases, death. COVID-19 primarily spreads through respiratory droplets emitted during coughing, sneezing, and speaking. Recent research has also indicated a link between COVID-19 and preeclampsia, a condition characterized by elevated blood pressure during pregnancy.

Several risk factors have been identified that contribute to the severity of COVID-19. These include age, as older individuals are more susceptible, and preexisting health conditions such as respiratory and cardiovascular diseases, impaired renal function, and elevated D-Dimer and troponin levels. Furthermore, males over 50 years of age are at a higher risk of mortality due to COVID-19. As research continues, it is crucial to stay informed about the evolving understanding of COVID-19, its effects, and the necessary measures to lessen its impact.

COVID-19 and the Antepartum Period: Implications for Pregnant Women

The antepartum period refers to the duration preceding labor and delivery, involving the physiological changes experienced by the mother and the development of the fetus. However, during the COVID-19 pandemic, pregnant women are confronted with an increased risk of adverse outcomes, complications, extended hospital stays, intensive care unit (ICU) admissions, and even mortality. Pneumonia, a frequent complication of COVID-19, can progress to severe acute respiratory syndrome (SARS). Pregnant women with pneumonia related to COVID-19 are also at risk for sepsis, disseminated intravascular coagulopathy (DIC), secondary bacterial infections, and renal failure. The timing of COVID-19 infection during pregnancy can also significantly influence these outcomes.

References

Advice for the public on COVID-19. (2020). Retrieved November 28, 2020, from https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public

Dashraath, P., Wong, J. L., Lim, M. X., Lim, L. M., Li, S., Biswas, A., & Su, L. L. (2020). Coronavirus disease 2019 (COVID-19) pandemic and pregnancy. American Journal of Obstetrics and Gynecology, 222(6), 521-531. doi:10.1016/j.ajog.2020.03.021

Daribi, K., Awulachew, E., & Get, E. (2020). The effect of coronavirus infection (SARS-CoV-2, MERS-CoV, and SARS-CoV) during pregnancy and the possibility of vertical maternal–fetal transmission: A systematic review and meta-analysis. European Journal of Medical Research, 25(1). doi:10.1186/s40001-020-00439-w

How to protect yourself & others. (2020). Retrieved November 28, 2020, from https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/prevention.html

Long-term effects of COVID-19. (2020). Retrieved November 28, 2020, from https://www.cdc.gov/coronavirus/2019-ncov/long-term-effects.html

Mascio, D. D., Khalil, A., Saccone, G., Rizzo, G., Boca, D., Liberati, M., & Antonio, F. (2020). The outcome of coronavirus spectrum infections (SIRS, MERS, COVID-19) during pregnancy: A systematic review and meta-analysis. American Journal of Obstetrics & Gynecology MFM, 2(2), 100107. doi:10.1016/j.ajogmf.2020.100107

NR 327 Maternal-Child Nursing Covid-19 and Pregnancy

McIntosh, K. (2020, November 22). Coronavirus disease 2019 (COVID-19): Epidemiology, virology, and prevention (M. S. Hirsch & A. Bloom, Eds.). Retrieved November 28, 2020, from https://www.uptodate.com/contents/coronavirus-disease-2019-covid-19-epidemiology-virology-and-prevention

Mikami, T., Miyashita, H., Yamada, T., Harrington, M., Steinberg, D., Dunn, A., & Siu, E. (2020). Risk factors for mortality in patients with COVID-19 in New York City. SSRN Electronic Journal. doi:10.2139/ssrn.3588532

Mullins, E., Evans, D., Viner, R. M., O’Brien, P., & Morris, E. (2020). Coronavirus in pregnancy and delivery: Rapid review. Ultrasound in Obstetrics & Gynecology, 55(5), 586-592. doi:10.1002/log.22014

Rasmussen, S. A., Malian, J. C., Lednicky, J. A., Wen, T. S., & Jamieson, D. J. (2020). Coronavirus disease 2019 (COVID-19) and pregnancy: What obstetricians need to know. American Journal of Obstetrics and Gynecology, 222(5), 415-426. doi:10.1016/j.ajog.2020.02.017

Ruthann, H. A., & Byrareddy, S. N. (2020). The epidemiology and pathogenesis of coronavirus disease (COVID-19) outbreak. Journal of Autoimmunity, 109, 102433. doi:10.1016/j.jaut.2020.102433

NR 327 Maternal-Child Nursing Covid-19 and Pregnancy

Schwartz, D. A. (2020). The effects of pregnancy on women with COVID-19: Maternal and infant outcomes. Clinical Infectious Diseases, 71(16), 2042-2044. doi:10.1093/cid/ciaa559

Signaled, S. S., & Kalan, M. E. (2020). Care of newborns born to mothers with COVID-19 infection: A review of existing evidence. The Journal of Maternal-Fetal & Neonatal Medicine, 1-13. doi:10.1080/14767058.2020.1777969

Yang, H., Wang, C., & Poon, L. C. (2020). Novel coronavirus infection and pregnancy. Ultrasound in Obstetrics & Gynecology, 55(4), 435-437. doi:10.1002/uog.22006

NR 327 Assignment 4 Care in the Postpartum Period

Name

Chamberlain University

NR-327: Maternal-Child Nursing

Prof. Name

Date

Questions

1. Explain the physiological changes that occur during the postpartum period.
2. Describe nursing assessments and nursing care during the postpartum period.
3. Discuss expected outcomes and interventions for common nursing diagnoses.
4. Explain the nurse’s role in health education and identify critical teaching areas.
5. Compare nursing assessments and care for women who have undergone cesarean and vaginal births.

Answers

Physiological Changes in the Postpartum Period: Understanding the Body’s Recovery

The postpartum period is a pivotal time for new mothers as they undergo substantial physiological changes following childbirth. Understanding these transformations is crucial for providing appropriate care and support during this transitional phase. One of the primary changes during this period is uterine involution, which refers to the uterus returning to its pre-pregnancy size. After delivery, the uterus gradually contracts, facilitating healing and minimizing the risk of complications. New mothers may experience afterpains and mild cramping due to uterine contractions, which are intensified during breastfeeding, aiding in both involution and the expulsion of any remaining placental fragments.

Another noteworthy change is the discharge known as lochia, which occurs after childbirth. Lochia is composed of blood, mucus, and uterine tissue and serves as an indicator of the involution process. Initially, lochia appears bright red and may be heavier in volume, transitioning over time to a pinkish or brownish hue and eventually to a yellowish-white discharge. Monitoring the characteristics of lochia is critical for ensuring that uterine involution proceeds normally. Additionally, the cervix undergoes changes, often appearing flabby with minor tears or lacerations. It may also be edematous, leading to discomfort. Similarly, the vagina, having been significantly stretched during childbirth, takes time to regain its thickness, which typically occurs when estrogen production from the ovaries resumes.

NR 327 Assignment 4 Care in the Postpartum Period

The perineum, located between the vagina and anus, also experiences notable changes during childbirth, becoming edematous and bruised due to the pressure and stretching experienced in the second stage of labor. Lacerations or episiotomies may be performed and contribute to postpartum discomfort. Therefore, proper perineal care and effective pain management are essential for healing and alleviating discomfort. Additionally, pregnancy influences the body’s coagulation processes, increasing the ability to form blood clots as a protective measure against postpartum hemorrhage. After childbirth, the body gradually normalizes its coagulation process, making monitoring vital to prevent excessive bleeding or clotting disorders.

Cardiovascular changes are also significant during the postpartum period. The increase in cardiac output due to elevated stroke volume during pregnancy can last for approximately 48 hours after delivery. However, most women experience a return to pre-pregnancy cardiac output levels within 6 to 12 weeks. Furthermore, the body eliminates the excess plasma volume accumulated during pregnancy through diuresis (increased urine production) and diaphoresis (increased sweating). Other physiological systems also undergo changes, such as an elevated white blood cell count during labor and the immediate postpartum period, which helps defend against infections. Hormonal fluctuations occur as the body readjusts following the cessation of pregnancy-related hormone production.

Nursing Care in the Postpartum Period: Observing for Hemorrhage and Assessing Patient Needs

Nursing care during the postpartum period involves diligent observation for signs and symptoms of bleeding, a potentially severe complication. Nursing assessments should include monitoring urinary output, assessing for bladder distention, and evaluating signs of urinary tract infections. Bladder distention can impede uterine contractions and contribute to bleeding, making it essential to ensure the mother can adequately empty her bladder. Observing for swelling or bruising around the urethra is also important, as these may indicate trauma from childbirth. If a urinary catheter is utilized, it should be regularly assessed to prevent infections.

Breast assessments are crucial for mothers intending to breastfeed. Nurses should evaluate the breasts for signs of engorgement, tenderness, or mastitis (infection of the breast tissue). Providing guidance on proper positioning and latch-on techniques is essential for successful breastfeeding. For mothers who choose not to breastfeed, it is vital to offer education on suppressing lactation and relieving discomfort.

Summary

In summary, nursing care during the postpartum period encompasses thorough assessments to monitor recovery progress and identify potential complications. This care includes evaluating uterine involution, observing changes in lochia, assessing the cervix, vagina, perineum, and breasts, monitoring vital signs, evaluating the urinary system, and providing support based on the mother’s feeding preferences. Through careful observation and proactive interventions, nurses play a critical role in promoting the well-being of postpartum mothers.

References

Murray, S. S., & McKinney, E. S. (2014). Foundations of maternal-newborn and women’s health nursing. St. Louis, Missouri: Elsevier.