Alyssa Thomas Sims Clinical notes PDF

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Simulation for Alyssa Thomas. Care of a pregnant woman...

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Alyssa Thomas 1. What are the nursing consideration when administering Pitocin to a client for labor augmentation? When else may we use Pitocin and why? The nurse needs to be aware of peripheral vessel dilation (a side effect of Pitocin that may cause hypotension). Assess the woman’s blood pressure every 15 minutes, assess vital signs. Monitor uterine contractions, as well as, fetal heart rate. Contractions should occur no more often than every 2 minutes, should not be longer than 70 seconds, and not stronger than 50 mmHg. Stop IV infusion immediately if contractions become more frequent or longer than the safe limits or if there are signs of fetal distress. Monitor intake and output appropriately watching for signs of water intoxication. The nurse is also responsible for titrating Pitocin as ordered. Pitocin is also used to stop or treat bleeding after birth or abortion. 2. What are some non-pharmacologic methods of providing pain relief/support? Hypnosis, aromatherapy, Breathing techniques, guided imagery, walking, rocking, positional changes, application of heat or cold, sacral counterpressure, music, focal points, dim lighting, massages and distraction. Getting in a tub of water or sitting on a gym ball. 3. When admitting a new patient in labor, what are they key labs and assessment information that is needed to provide the best care for a patient? Firstly, we need to establish a therapeutic relationship for the comfort of the mother and support person. We need pertinent information about the pregnant woman health history including; blood type and allergies, previous illnesses, labor and delivery plan. Vital signs, physical exam, contraction pattern, intactness of membranes through vaginal exam, and fetal well-being through fetal heart rate monitoring. Urinalysis – clean catch urine sample, CBC blood test, HCT, ABO typing blood test (if not previously done)...