Question

Please help me with two care plan and two nursing diagnosis for this case scenario?

Nursing Care Plarn Faculty: Ibironke Balough Date: Rosie is a primigravida at 43 weeks of gestation. Her labor is being stimulated with oxytoci IV. Her contractions have been increasing in intensity with a frequency of duration of 80 to 85 seconds. She is currently in a supine position with a 30-degree elevatiosn head. On observation of the monitor tracing, you note that during the last two decreased to 120 BPM after the contraction about 10 seconds into the rest period. Write a nursing care plan for Rosie. every 2 to 2 % minutes and a contractions, the FHR peaked and did not return to baseline of 155 BPM until A slight decrease in variability and baseline rate was observed. Your care plan should consist of detailed assessment data pertaining to the client. This nursing diagnosis, 3 nursing interventions with a ratonal for each, and 1 expected outcome. includes 1 goal, 1 Nursing interventions Rationale Expected outcome NANDA approved nursing State subjective All parts must 1. Directly 1. Independent and objective be included related to 2. Collaborative data to support (related to, the nursing 3. Student's choice references Goal partially met? Use scholarly Goal met? e nursingAEB) as diagnosis diagnosis ppte 2 Preciust Goal not met? Must be priority Nursing measurable nursing dx and goal concise, apply directly to (explain) diagnosis. and realistic, Example: pain cannot Differentiate be relieved in the short orinterventions treating appropriate. pain doesn't relieve. Write: Goal cannot be met itn the absence of direct interventions to impact the goal No points for whetherabsence of partially correct nursing long term is the pain. Assessing diagnosis Simply state the what happened in order for goal to be met or not State what you intend patient will to do (always start with a verb) eated May 3 3010

Answer 1

Nursing care plan for Rosie :-

Nursing assessment - The fetal heart rate decreased to 120 bpm after contraction peaked

Nursing diagnosis - decreased fetal heart rate related to uterine contraction.

Goal - To maintain a normal fetal heart rate between 160-170 bpm

Nursing interventions - Assess the vitals of the mother and fetus continuously so that actions can be taken immediately

- Continuous monitoring of fetal heart rate to prevent any complications

- Decrease the flow rate of oxytocin to decrease severe contraction that fetus can't tolerate to avoid fatal complications

- Elevate the head end to 30 degree and advice deep breath to expand lungs of mother for more oxygen to the baby .

Evaluation - Evaluate one the intervention are done to see whether there is any improvement in the fetal heart or not and if not then inform the physician again and take prompt actions like ready for delivery