Question

Nursing care plan.

Nursing Management of Labor and Birth at Risk.

Carol, age 17, is pregnant with her first child. Her menstrual dates are accurate and her date of conception is limited to one possible day. Her physician gives her an EDC of March 28^th. Carol has gone past her due date and refuses to have her labor induced. Carol states, “My grandmother says that the baby will come when it is good and ready.” It is now April 14^th and Carol is at 42 3/7 weeks' gestation. She calls the office and reports that she is having a significant lower backache and she just passed “a glob of bloody mucus” from her vagina.

1. Develop 3 NANDA Priority Nursing Diagnosis:

2. State Patient Goals/Plan Nursing Diagnosis:

3. Write Interventions for Your Plan:

4. Scientific Rationale for Interventions:

5. Write How You Would Evaluate Your Plan:

6. List of Medications Typical for the Medical Dosage; side effects.

   Educational Consideration:

Answer 1

1. The NANDA diagnosis would be

1 Risk for fetal complications related to postmaturity

2 Risk for maternal complication related to patients refusal of induction of labour

3 Anxiety related complications of delivery by induction

2 Goals

1 fetus undergoes delivery without complications

2 patient demonstrates importance of induction of labour, maternal health maintained by preventing complications

3 patient demonstrates relaxation techniques to reduce anxiety, verbalise reduction in anxiety

3. The interventions and scientific rationale

1 * carefull assessment in order to identify and prevent the complications

* fetal monitoring for detecting fetal issues

* notify the pediatrician about risk for baby and arrange necessary articles

2. * assess the mothers condition

* educate the importance of induction of labour to patient and family

* prepare for a difficult delivery

3.* assess the level of anxiety

* encourage the mother to ask doubts

* clarify the doubts of mother

* educate and demonstrate deep breathing exercises to relax herself.

5. Evaluating the plan

1. Assess the complications occurred to the fetus such as any birth injury

2. Asses the maternal complications like difficult labour

3. Patients verbalization of coping strategies and demonstrating it

6. The medications for induction of labour is IV oxytocin

Dosage initially 0.5 to 1milliunits/ minute at 30-60 min interval. Usually maximum of 9 to 10 milliunits/ minute

Side effects : more intense contraction, excessive bleeding after birth, seizures, shallow breathing nausea vomiting

Educational consideration

* explain the adverse effects and get consent

* maternal monitoring and fetal monitoring