Question

Please help me write exemplars for these.

1. Discusses a selected evidence-based maternity nursing intervention observed in the clinical setting.

2. Identify therapeutic nursing interventions utilized, observed or discussed in clinical settings to meet the needs of the maternal-newborn client and family.

3. Identify and/or utilize therapeutic communication techniques to support and counsel the client or family during the maternity cycle.

4. Collaborates as a member of the interprofessional health care team in providing nursing care to maternal-newborn clients.

Answer 1

1. Kangaroo mother care is an evidence based maternity nursing intervention which benefits both mother and newborn .

Benefits to the parent :-

- improves bonding , feeling of closeness

- increase breast milk production

- increases confidence to care a newborn

- promotes a sense of control

Benefits to the newborn :-

- brain development

- stabilization of breathing , heart rate , oxygenation etc

- regulates temperature

- successful breastfeeding

- decreases crying

2. Nursing interventions utilized, observed or discussed in clinical settings to meet the needs of the maternal-newborn client and family are :-

Assess the woman’s family profile to determine the impact that the newborn would give to the family and to the woman.

Assess the woman’s pregnancy history, especially if the pregnancy was planned or unplanned as it will determine the ability of the woman to bond with the newborn.

Assess the labor and birth history such as the length of labor and if any analgesia or anesthesia was used to determine any necessary procedures to be done.

Determine the infant’s data and profile to help with planning the care of the newborn and promote bonding between the parents.

The woman would also need a postpartum course such as her activity level after birth, any difficulties or pain felt, and if she is successful with infant feeding to determine any need for anticipatory guidance in home care.

Assess any laboratory data of the woman to be certain that she is recovering well and if any procedures or additional diagnostic tests need to be performed.

Assess the woman’s general appearance because it is a reflection of how well the woman is moving into the taking hold phase of recovery.

Assure the woman that losing a quantity of her hair is not a sign of illness but because she is returning to her nonpregnant state, as hair grows rapidly during pregnancy because of increased metabolism.

Assess for facial edema, especially for a woman with pregnancy-induced hypertension.

Advise the woman to purchase a nursing bra that is one to two sizes larger than her pregnancy size to allow for increase.

Assess the woman’s breast for any cracks or fissures, and avoid squeezing the nipple. Also, assess for signs of mastitis such as inflammation of a certain part of the breast.

Assess the location, consistency, and height of the fundus through palpation.

If the uterus is not firm upon palpation, massage it gently. Placing the infant on the mother’s breast also aids in stimulating contractions.

Lochia is expected in a postpartum woman for 2 to 6 weeks, so assessment of its characteristics is necessary to determine if it is the normal lochia or not.

Observe the perineum for ecchymosis, hematoma. Edema or any drainage and bleeding from the stitches.

Care in Preparation for Discharge :-

Before the woman is discharged, she must be educated properly regarding the care of the newborn and herself at home.

Assess first the ability of the mother to absorb new instructions and to listen.

Conducting group classes regarding newborn care could greatly help mothers learn not only what the instructors teach but also from the experiences that some mothers could share to the group.

It is also recommended for fathers to attend such classes so the mother would have someone she can rely on with the newborn care.

Individual instruction is also sought after postpartum, as the family will need to know how to care for the woman and the newborn after discharge.

Teaching should not always be formal; it may come in the form of comments during classes or procedures.

Instruct the woman to avoid lifting heavy objects for the first three weeks after birth.

Advise the woman to allot a rest period every day, or to rest and sleep while her newborn is also asleep so she can regain her energy.

Be certain that the woman is aware that she must return to the healthcare facility after 4 to 6 weeks for examination and that she must arrange an appointment.

3. Therapeutic communication techniques to support and counsel the client or family during the maternity cycle are :-

Using silence - allows client to take control of the discussion, if he or she so desires • Accepting - conveys positive regard • Giving recognition - acknowledging, indicating awareness Offering self - making oneself available • Giving broad openings - allows client to select the topic Offering general leads - encourages client to continue • Placing the event in time or sequence - clarifies the relationship of events in time • Making observations - verbalizing what is observed or perceived