Question

Chapter 1 Obstetrical Cases 35 2 Mother A, a gestational diabetic, delivered a 37 week, 10 lb. 2 oz. baby boy vaginally one hour ago. You note the following data: mother's blood type 0+, rubella immune, fourth degree lac- eration, swollen perineum, fundus 2 cm. above the umbilicus deviated to the right and boggy voided 50 cc, lochin large rubra with small clots, breasts soft and nontender (SNT), T 98.6, P.110, R. 20. BP 80/50, blood sugar 90. 1,000cc LR 125/hr.with 10 units of Pitocin infuses into R arm. Mother A complains of painful perineum, an B on a scale of 1-10 Focus Questions 1. What nursing intervention is a priority considering the data given, and why? 2. What is the meaning of a blood sugar of 90 (use pathophysiology of gestational diabetes to describe your answer)? 3. Give three nursing interventions that might help to relieve the client's pain. Mother B delivered a 5-pound baby girl at 42 weeks gestation yesterday morning by a sponta- neous vaginal delivery. Apgar scores were 5 and 7. Mother B has a history of alcohol and cocaine use as well as a history of hepatitis B. During report today you learned that she refused to feed her baby and asked for the baby to be returned to the nursery. Mother B's temperature at noon is 100.8°, P. 110, R. 32. She complains of chills and severe after-pains and has a foul smelling rubra lochia. The next morning her temperature is 101°F, and she is asking for more pain medication. Focus Questions 1. What postpartum care is standard for all mothers who have delivered, and what is the rationale for this routine?

Answer 1

Q1. She is case of post partum haemorrhage beacuse it bp fall 80/50 due to severe blood loss through perineal tear

She goes to shock because she developed severe hypotension do to blood loss

So primary intervation for secure his airway , maintenance of breathing and circulation

Apply immediately iv canula to patient and start normal saline

Pervent from shock , control bleeding and manage 3-4 unit blood ,and sift patient to operation theater

Q2 gestational diabetes- normoglycemic female conceve after 24-28 wk develop hyperglycemia do to insulin resistance develop in pregnancy