History/ Information Past medical history: Patient is apparently…

Question Answered History/ Information Past medical history: Patient is apparently… History/ InformationPast medical history: Patient is apparently healthy woman who has been married for two years. She denies surgery or previous health problems except for occasional episodes of asthma that resolve with albuterol inhaler as needed. Her last inhaler use was 2 weeks ago. She denies smoking, recreational drug use or alcohol use. No known drug allergies.Familiar history: Mother: hypertension at age 40; hysterectomyat age 42 and diabetes at age 45               Father: myocardial infarction at age 58Labor and DeliveryThis patient is a 35-year-old female gravida 1, para 0. She is 37 weeks and pregnant with twins. Her blood type is A negative. She has a history of occasional episodes of asthma and has used the inhaler three times this pregnancy. The patient was diagnosed with preeclampsia at 30 weeks gestation and is scheduled for an augmentation of labor.  The patient had blood pressure reading reaching 150/95 and a trace urine protein noted. A urinary catheter was inserted following the epidural anesthesia and removed prior to the second stage of labor. The patient delivered twins (Twin A-boy and Twin B- girl) vaginally after 16 hours of labor, both cephalic presentations. Twin A weighed 7 pounds 3 ounces and Twin B weighed 7 pounds 6 ounces. She had an episiotomy with a third degree extensionthat was repaired. No other lacerations were indicated on the delivery record. Estimated blood loss was 700ml. There was unusual bleeding or blood clots noted upon fundal massage.Postpartum AssessmentAfter 2 hours the patient was transferred to the postpartum unit with husband and twins at bedside. The patient is oriented to the room and a new perineal pad is applied to the patient during the initial assessment. After one hour the patient press the call light and states she feels blood dripping down her leg. Upon assessment you note a boggy uterus deviated to the right side,her pad is saturated, and there is a constant flow of blood. You perform a fundal massage and the uterus is firm after 2 minutes. You apply a new pad and inform the patient that you will return in 15 minutes. After 15 minutes you return to the patient room to assess her bleeding. The pad is saturated again, fundus is boggy, abdomen is distended and you notice blood clots.  The palms of her hands are sweaty , she’s complaining of abdomen pain and feeling dehydrated. The patient and the husband are concern about her condition.Questions:1. What is your plan of action of this patient?2. How would you explain this situation to the patient and her husband?3. Would you consider calling the physician and why?4. Would orders do you anticipate the physician to order and why?5. What would be the primary nursing diagnosis?1. Identify four different kinds of therapeutic groups an RN could conduct.          Then, pick one of those therapeutic groups and:2. Explain the value the group work might bring to clients with mental health problems. 3. Discuss 2 different roles that the nurse may take when conducting the group.4. Identify various ways to get patients to participate. 5. How will you handle each of the following? -A group member who is monopolizing the conversation and will not let others speak -A group member who is silent and appears very uncomfortable.  Health Science Science Nursing Share QuestionEmailCopy link Comments (0)

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