Maternal health is a course taken in the nursing school where some of the essential topics coved in the study include: nursing care during postpartum, high-risk newborn and maternal care, nursing when a patient is experiencing loss of the pregnancy, nursing care during pregnancy, and finally fetal development and contraception. To better understand the topic, different case studies get carried out to evaluate the patient's condition, plan of care, diagnosis, interventions, and evaluations.
Topic 1: Nursing care during postpartum
A 28-year-old female with Postpartum Hemorrhage and increased vaginal bleeding (G1P1) is readmitted two weeks post-vaginal delivery.
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Plan of care
Assessment
The nurse should assess the uterus' condition, amount of bleeding, check the maternal vital signs as they observe the shock, which will help minimize the chances of complications.
Nursing Diagnosis
Deficient Fluid volume is one of the possible issues related to the bleeding after giving birth.
Plan
The nurse’s intervention will be to manage the patient making sure they avoid any further complications.
Intervention
The nurse should assess and record the site and amount of the bleeding and make sure they weigh and count the perineal pads and try saving the blood clots, if possible, for evaluation by the physician.
Evaluation
The nurse will monitor whether the patient maintains blood pressure of at least 100/60 mmHg and the patient's cognitive status within the required range.
Topic 2: High-Risk Newborn and Maternal Care
A 1550g preterm infant has a standard Apgar score, and after delivery appears healthy, and the infant gets transferred to a nursery to get furthers care.
Plan of care
Assessment
They should also check the newborn's head and neck, even the face, lung, mouth, heart sound, and pulse in the femoral (groin).
Nursing Diagnosis
Because the neurological system is not wholly developed at the time of birth, the nurses can conduct a thermoregulation procedure to help in the neurological system adoption.
Plan
If the baby's condition shows signs of complications, the baby should be taken for instant medication where the baby will get examined for reflux, which is vital in saving the newborn's health and life.
Intervention
The intervention for high-risk infants begins when the newborn is first delivered. The intervention aims to promote the newborns' well-being as it minimizes the developmental growth and enhances the competencies.
Evaluation
The newborn is only clarified sick if the vital signs get abnormal. Although generally, the essential characters of high-risk newborn babies are standard, and that is what the nurses need to evaluate the typical symptoms of a newborn baby to detect any abnormality.
Topic 3: Nursing when a Patient is Experiencing the loss of Pregnancy
The patient is a 23-year-old female who complains of a recurrent pregnancy loss where the patient has experienced two miscarriages where the first took place in 11and 12 weeks gestation.
Plan of care
Assessment
After a nurse’s assessment, the patient showed no physical abnormalities. The hysterosalpingogram and transvaginal ultrasound showed normal results ( Peahl, 2020 ).
Nursing Diagnosis
The patient’s hypothyroidism was out of control according to the te4sts that were run, and the prolactin levers were also high and needed regulation.
Plan
The main aim is to make sure that the patient’s hypothyroidism gets well regulated with Synthroid. The care was also to make sure that they lowered prolactin levels in the patient's body.
Intervention
The nurses need to anticipate an exaggerated and increased affective behavior, and they are also obliged to initiate processes that attract additional rescores and support.
Evaluation
With the hypothyroidism getting controlled through Synthroid and prolactin leveled to normal, the whole care plan was a success.
Topic 4: Nursing Care During Pregnancy
A 25-year-old patient reported premature labor and all signs of miscarriage, and according to the patient’s condition and the explanation she gave, she has not been feeding appropriately ( Tunçalp et., al,2017) .
Plan of care
Assessment
The nurses have to check the gastrointestinal system.
Nursing Diagnosis
Nurses should run a blood test on the patients to identify the blood group, rubella, Hepatitis B, syphilis, anemia, blood type, and the Rh factor.
Plan
The main goal for nursing care during pregnancy is to ensure that the mothers deliver safely and appropriately without complications for both the mother and the newborn.
Intervention
The prenatal nurses offer pregnant mothers assistance to recognize and avoid issues that may present during, before, and after birth.
Evaluation
The parental nurses' care helps many mothers, including the patient who is given medication and the guidelines on her diet.
Topic 5: Nursing Care of the Newborn
A newborn baby born at 32 2/6 weeks gestation with a dermopathy restrictive who passed away at five weeks of age genodermatosis laminopathy ( Tunçalp et., al,2017) .
Plan of care
Assessment
The need for an environment that is neutral, sepsis evaluation, and nutrition support were the issues that the nurses looked d into and the rear restrictive dermopathy disorder.
Nursing Diagnosis
Some of the nursing care of neonatal sepsis include the test for hyperthermia, an interrupted schedule of breastfeeding, and the fluid volume deficit.
Plan
The care's primary goal is to protect the newborn from contracting a sepsis onset that appears mostly in the first 24 hours of the newborn's life.
Intervention
For the interventions, the nurses need to monitor the neonate's condition and provide all the TSB signs while monitoring the vital signs.
Evaluation
If the procedures are successful, the newborn will maintain the average core temperature, which will be affirmed by holding the vital signs within normal limits.
Topic 6: Nursing Care on pregnancy and facials
A 39-years old mother on her nine-months of pregnancy explains to have to scare skin irritation and break-outs where she complains that it has recently been so severe.
Plan of care
Assessment
The nurses need to assess the patient by questioning the kind of facials she has been receiving.
Nursing Diagnosis
Since the patient has presented signs such as scarring of the skin irritation and break-outs, the most likely problem might be the microdermabrasion or retinoid generated from vitamin A ( Tunçalp et al.,2017) .
Plan
The plan is to minimize the consumption of vitamin A to avoid Retinoid.
Intervention
The patient needs to get advice on how they will change the facials they have been receiving and move to safe facials during the pregnancy, such as oxygen facials, hydrating facials, and deep cleaning.
Evaluation
After the patient changes the facial, she started registering some changes on her face, and the irritations reduced, which was a complete success.
Topic 7: Nursing care for Preterm Labor
The patient is a 19-year-old unmarried female who is pregnant for the third kid and had conducted an abortion when fifteen, and she is in the eighth week of gestation.
Plan of care
Assessment
The patient experienced discomfort and is going through so much pain due to the fetus she requested a stop of medication, and the risks of the actions were explained to her.
Nursing Diagnosis
The patient was asked to avoid smoking or any person smoking around her. Therefore activity intolerance was explained to her too.
Plan
The main goal of the treatments is to make sure that the mother does not deliver prematurely.
Intervention
Interventions for the condition involve monitoring the vital maternal signs and assessing the support system available for the patient even though the patient has to return home or remain hospitalized (Boyles. et al.,2020) .
Evaluation
The measures taken by the nurse registered success. And the patient delivered safely, and the newborn was healthy.
Topic 8 examples: Precipitous Labor
A 28-year-old G4P3 woman visited the clinic during her third trimester and complained of her contractions being too strong.
Plan of care
Assessment
The nurse will need to assess past medical and surgical history. The nurse will check the vital signs such as blood pressure, respiratory rate, heart rate, temperature, and pulse oximetry.
Nursing Diagnosis
There is a low fluid volume caused by fluid loss through the forceful contraction, regular routes, and premature separation of the placenta.
Plan
The patient should identify the individual risk factor and demonstrate behavior changes to prevent fluid deficit development ( Tunçalp et al.,2017) .
Intervention
The nurse should note the woman's level of consciousness to assess the ability to express her needs and preferences, monitor vital signs, encourage oral intake.
Evaluation
The woman should deliver the baby safely and have sufficient fluid during delivery.
Topic 9: Contraception and Fetal development
A 30-year-old woman G1PO at nine and a half weeks visits a clinic, and during the interview, she tells the nurse that she has frequent urination and is nauseated, which makes it difficult for her to eat.
Plan of care
Assessment
The nurse should access the patient’s regular bladder functioning pattern to offer a basis for comparison.
Nursing Diagnosis
Abnormal urinary functioning is associated with the regularity of lesser to physiologic pregnancy changes (Boyles. et al.,2020).
Plan
The nurse should promote standard urinary elimination patterns.
Intervention
The nurse should suggest that the client avoid caffeinated drinks, encourage her to do kegel exercises, and discuss the physiologic cause for increased urination frequency during pregnancy.
Evaluation
The patient will report a decrease in urinary complaints, which will be evident from the reduced several times she goes to the bathroom to urinate.
Topic 10: Nursing Care During Childbirth,
The patient is a 32-year-old female admitted to the hospital. She is not sure of her due date, but she tells the nurse that she has been experiencing close contractions.
Plan of care
Assessment
The woman should be placed under observation during labor. This will enable the nurse to observe her progress and ensure safe delivery for her and the infant ( Tunçalp et al., 2017) .
Nursing Diagnosis
There are signs of placental expulsions, such as a sudden gush of vaginal blood, an increase of the umbilical cord, and a change in the uterus.
Plan
The woman has a small vagina. Therefore, an episiotomy should be performed, and there is a need for perineal repair.
Intervention
The nurse should observe and review the client’s breathing techniques and offer a relaxed environment to help in the patient's efficient coping management.
Evaluation
For safe labor and delivery, the client should have the right tolerance level of pain. She should report that the setting is relaxed and secure and express her preferences during labor.
Conclusion
Conclusively the course has helped understand maternal health and enlighten both on how well they can handle maternal situations. Through the various scenarios, one is aware of handling the patient, assessment, and the necessary steps for intervention.
References
Boyles, A. L., Beverly, B. E., Fenton, S. E., Jackson, C. L., Jukic, A. M. Z., Sutherland, V. L., ... & Chandler, K. J. (2020). Environmental factors involved in maternal morbidity and mortality. Journal of Women's Health. https://www.liebertpub.com/doi/abs/10.1089/jwh.2020.8855#
Peahl, A. F., Smith, R. D., & Moniz, M. H. (2020). Prenatal care redesign: creating flexible maternity care models through virtual care. American journal of obstetrics and gynecology, 223(3), 389-e1 . https://doi.org/10.1016/j.ajog.2020.05.029
Tunçalp, Ӧ., Pena‐Rosas, J. P., Lawrie, T., Bucagu, M., Oladapo, O. T., Portela, A., & Metin Gülmezoglu, A. (2017). WHO recommendations on antenatal care for a positive pregnancy experience—going beyond survival. BJOG: An International Journal of Obstetrics & Gynaecology, 124(6), 860-862. https://doi.org/10.1111/1471-0528.14599
