Ob Diabetes
CASE STUDY 01 (POSTPARTUM)
Assessment
A 1,000 ml bag of Lactated Ringer's solution containing 10 units of Pitocin (oxytocin) is infusing via an 18 g peripheral IV in the left forearm at 125 ml per hour, with 300 ml remaining in the bag. The IV is patent, without redness or swelling, and can be discontinued when this bag's infusion is complete.
1. Prior to discontinuing the IV Pitocin (oxytocin), which assessment is most important for the nurse to obtain?
[pic]A) Vital signs.
[pic]B) Vaginal discharge.
[pic]C) Uterine firmness.
[pic]D) Oral intake.
2. What is the priority nursing diagnosis for Marie, who is experiencing residual effects of epidural anesthesia?
[pic]A) Risk for injury.
[pic]B) Impaired physical mobility.
[pic]C) Altered urinary elimination.
[pic]D) Risk for infection.
3. What is the priority nursing action to address Marie's needs related to the repair of her 4th degree perineal laceration?
[pic]A) Provide prescribed oral pain medication and stool softener.
[pic]B) Encourage warm sitz baths 2 to 3 times daily.
[pic]C) Apply perineal ice packs consistently for the first 24 to 48 hours.
[pic]D) Teach proper and frequent use of the peri-bottle.
Early detection of, and intervention for, postpartum complications promotes positive client outcomes. Postpartum protocol requires that the nurse assess Marie's vital signs, fundus, perineum, vaginal bleeding, pain, leg movement, and IV every 15 minutes for the first hour and then every hour for the next three hours.
4. Considering Marie's history, which postpartal complication is she most at risk for?
[pic]A) Endometritis.
[pic]B) Subinvolution.
[pic]C) Deep vein thrombosis.
[pic]D) Hemorrhage.
Postpartum Crisis
Fifteen minutes after the initial assessment, the nurse finds Marie disoriented and lying on her back in a pool of vaginal blood, with the sheets beneath her saturated with blood.
5. What is the priority nursing action?
[pic]A)
Assessment
A 1,000 ml bag of Lactated Ringer's solution containing 10 units of Pitocin (oxytocin) is infusing via an 18 g peripheral IV in the left forearm at 125 ml per hour, with 300 ml remaining in the bag. The IV is patent, without redness or swelling, and can be discontinued when this bag's infusion is complete.
1. Prior to discontinuing the IV Pitocin (oxytocin), which assessment is most important for the nurse to obtain?
[pic]A) Vital signs.
[pic]B) Vaginal discharge.
[pic]C) Uterine firmness.
[pic]D) Oral intake.
2. What is the priority nursing diagnosis for Marie, who is experiencing residual effects of epidural anesthesia?
[pic]A) Risk for injury.
[pic]B) Impaired physical mobility.
[pic]C) Altered urinary elimination.
[pic]D) Risk for infection.
3. What is the priority nursing action to address Marie's needs related to the repair of her 4th degree perineal laceration?
[pic]A) Provide prescribed oral pain medication and stool softener.
[pic]B) Encourage warm sitz baths 2 to 3 times daily.
[pic]C) Apply perineal ice packs consistently for the first 24 to 48 hours.
[pic]D) Teach proper and frequent use of the peri-bottle.
Early detection of, and intervention for, postpartum complications promotes positive client outcomes. Postpartum protocol requires that the nurse assess Marie's vital signs, fundus, perineum, vaginal bleeding, pain, leg movement, and IV every 15 minutes for the first hour and then every hour for the next three hours.
4. Considering Marie's history, which postpartal complication is she most at risk for?
[pic]A) Endometritis.
[pic]B) Subinvolution.
[pic]C) Deep vein thrombosis.
[pic]D) Hemorrhage.
Postpartum Crisis
Fifteen minutes after the initial assessment, the nurse finds Marie disoriented and lying on her back in a pool of vaginal blood, with the sheets beneath her saturated with blood.
5. What is the priority nursing action?
[pic]A)