University:
West Coast University
Course:
NURS 664 | Primary Care Women's Health: Theory, Pharmacology and Practice
Academic year:

2020
Views:

266

Pages:

2
Author:

gewoekerdodx

Maternity Case 5: Fatime Sanogo Guided Reflection Questions Opening Questions How did the simulated experience of Fatime Sanogo’s case make you feel? I was surprised at the amount of lochia on her bed pads. I wished that the husband would not have been so distracted and would have noticed a change in his wife’s behavior instead of playing on his phone the entire time. I was also pretty confused on what to do after each doctor’s order was completed. Describe the actions you felt went well in this scenario. I knew to immediately put her in the Trendelenburg position during my initial assessment, then obtained the most accurate information and gave her a fundal massage, then I phoned the provider. She received the appropriate medications and interventions at the right time. Scenario Analysis Questions* EBP/I What risk factors did you identify in Fatime Sanogo’s case that could have led to postpartum hemorrhage? Postpartum Hemorrhage risk factors that Fatime Sanogo presented with were her rapid delivery, manual removal of the placenta, second degree perineal laceration, oxytocin infusion, and a 9 lb baby. EBP List the actions that should be initiated if administering oxytocin is ineffective. A Fundal massage, fluid bolus, and notify physician. If it is uncontrolled, charge nurse should be notified to see if rapid response notification is recommended. EBP What were the assessment findings in Fatime Sanogo’s case that indicated her condition was worsening? She had a large amount of discharge, and her uterus was soft and boggy. Her heart rate was high, and her blood pressure was dropping. PCC What communication techniques could be initiated to decrease the anxiety of Fatime Sanogo and her husband and provide care that is culturally sensitive? I would educate them as to what a postpartum hemorrhage is, and how we are working on it already—catching the bleeding soon while she is already in the hospital is very * important and a positive thing. I would calm and support them, and let them know we have religious services and other support services available at their request. T&C How important do you feel it is to include Fatime Sanogo’s husband as a member of the health care team? Why? It is important to keep him included because in their culture the husband is often the head of the household and makes the decisions, and not doing this would be disrespectful and culturally inappropriate. Concluding Questions Reflecting on Fatime Sanogo’s case, were there any actions you would do differently? Explain. In the first scenario, I wanted to talk to the provider before intervening, but it was more important to assist her into Trendelenburg, perform a fundal massage and then assess vitals, lochia, and perineum before calling the provider in order to obtain the right data and relieve the symptoms as soon as possible. Describe how you would apply the knowledge and skills that you obtained in Fatime Sanogo’s case to an actual patient care situation. In an actual patient care situation, I would continually monitor the lochia and pads and perineum, while keeping a consistent watch on the blood pressure, heart rate, and O2 status. I would also make sure to perform fundal massages and assess uterine tone while keeping a consistent communication with the provider to make sure any worsening of symptoms is caught before hemorrhage worsens.