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A Complete Solution to vSim for Nursing | Maternity and Pediatric

Olivia Jones

  1. Document the data from your focused antepartum assessment of both Ms. Jones and the fetus.
  2. Write the situation-background-assessment-recommendation (SBAR) communications you would use to update the provider on Ms. Jones’s status at the time of her admission.
  3. Document the teaching you would provide to the patient and her support person prior to administering magnesium sulfate.
  4. Document the administration of the magnesium sulfate bolus and the initiation of the magnesium sulfate infusion.
  5. Document your reassessment of the patient’s status after administering magnesium sulfate.

Answer

1

Olivia Jones, 23 years old African American Female, P1G0 at 36 weeks gestation, diagnosed with severe preclampsia. She is admitted to the labor and delivery unit suriveillance due to continue progression of preeclampsia, elevated blood pressure, weight gain headaches, epigastric and proteinuria.

2

Situation

Olivia Jones, 36 weeks gestation, diagnosed with severe preeclampsia. She is complaining of a headache that is not resolved with acetaminophen and epigastric pain. She is nausea and fatigue and she states of visual changes, tightness in the chest. She also states she is quieter than normal.

Background

Olivia Jones, an African American, 23 years of age , she is 36 weeks gestation.

Assessment

Reason for Olivia Jones’s admission is preeclampsia. Gestation is 36 weeks, weight is 110 kg, BP is 146/92, Temperatures is 99 F , HR is 110, RR:  12 breaths per minutes , 2+ tendon reflex, +1 pitting edema of the lower extremities, Lung sound clear, FH rate: 138, and fetal movement. Oxygen: 2L. Medication: magnesium sulfate, and anti hypertensive

Recommendation

Treatment includes education, continue monitoring the BP, HR, RR , oxygen, fetal HR, and comfort measures. Administration of anti hypertensive  IV medication, and magnesium sulfate ( side and adverse effects). Reduction of sensory stimulation, safety measures and surveillance, patient education, and support person, facilitating safety measures regarding patient care

3

Explain rationale to the patient and support person with the use of tocolytics to treat contraction and to try to prevent preterm birth.

Explain all procedures, equipment, medications, side effects, and answer all questions.

Allow for expression of anxiety considering infant prematurity. Arranging for  the staff of neonatal intensive care to visit the patient to answer questions that may be helpful.

Continually update patients and family on maternal and fetal status.

Begin patient education to increase knowledge and skills concerning preterm labor . Patient education is individualized by the following: medication administration, scheduling and side effects. Abdominal palpation and timing of contractions, importance of bed rest in later recumbent position, subtle signs or symptoms of preterm labor and the importance of immediate reporting symptoms, and adequate hydration.

4

Pertinent maternal and fetal assessments

Initiation of protocol used in patient care

All nursing and medical interventions and patient responses

Magnesium sulfate In grams per hour.

Initial and subsequent tocolytics dosages as well as time of dosage changes

Physician’s notification, including indication and response

5

Assess P.R and BP every 15 minutes first hours of infusion, and following any dosage increase every 30 minutes during the second hour of magnesium sulfate therapy. Also assess P.R and BP a minimum of once an hour during maintaining therapy.

 

 

Description

A Complete Solution to vSim for Nursing | Maternity and Pediatric

MATERNITY SCENARIO

Patient Introduction

Olivia Jones is a 23-year-old African-American female, G1P0 at 36 weeks of gestation. She has been diagnosedfatime with severe preeclampsia and is admitted to the labor and delivery unit for assessment and surveillance.

Pregnancy has been unremarkable until routine prenatal visit at 30 weeks with elevated blood pressure at 146/92 mm Hg, proteinuria, and developing mild preeclampsia. She has been on bed rest at home until prenatal visit today with increasing symptoms, resulting in admission.

She has gained 3 pounds since prenatal visit 1 week ago. Protein dipstick is +4, negative ketones, negative glucose, +2 dependent edema, and facial puffiness.

Ms. Jones is complaining of a headache that is not resolved with acetaminophen. She presents with nausea and fatigue and complaining of epigastric pain, visual changes, and chest tightness. The fetus is active; however, patient states that it is a bit quieter than normal. There is a possibility of premature rupture of membranes. An IV with lactated Ringer’s is running at 125 mL/hr. Labs were obtained.

 

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