Case Study #1 Diana is a healthy 35-year-old G5P5 who vagina

Case Study #1 Diana is a healthy 35-year-old G5P5 who vaginally… Case Study #1Diana is a healthy 35-year-old G5P5 who vaginally delivered an 8 pound, 6 ounce baby girl with an intact perineum. Her estimated blood loss (EBL) was 500 mL. During the fourth stage of labor her vital signs, fundus, and lochia were within normal limits (WNL). She is transferred to the mother-baby unit 3 hours after birth.=What is the postpartum period? =What is the process of uterine involution after childbirth? =How is postpartum hemostasis achieved? Case Study #1 (continued)After the report, the nurse goes in to assess Diana. Her vital signs are WNL, but her fundus is 2 cm above the umbilicus and displaced to the right. Her sanitary pad is completely saturated with lochia rubra.=Is this an expected finding 3 hours after birth? Case Study #1 (continued)The nurse asks Diana to dangle her feet at the bedside for several minutes. After confirming that Diana does not feel dizzy or lightheaded, she helps Diana up to the bathroom to void.=Why does the nurse think that Diana’s bladder is full? =When Diana first gets out of the bed, she has a gush of blood. Is this a sign of hemorrhage? Case Study #1 (continued)Diana voids 500 mL of urine. Her fundus is boggy but became firm with massage and is now at the level of the umbilicus. Her lochial flow is slightly decreased. Diana has an IV of lactated Ringer (LR) solution with 20 units of oxytocin infusing at 125 mL per hour.=What else can the nurse do to help Diana’s uterus contract?Case Study #2Janelle is a 40-year-old G6P5. She gave birth to a 9-pound healthy male infant via normal spontaneous vaginal delivery 3 hours ago. She has no medical problems. Her pregnancy history was normal. Her labor course was normal, although her membranes were ruptured for 24 hours before delivery. She had no lacerations at delivery. Her body mass index (BMI) is 36.Her vital signs are T 99.6º F; P 118 bpm; BP 120/70 mm Hg; R 20 breaths/min. She has an intravenous (IV) infusion of lactated Ringer (LR) solution 1000 with 20 units of oxytocin.=What risk factors does Janelle have for postpartum hemorrhage?=What are the ongoing nursing assessments needed with Janelle? Case Study #2 (continued)The nurse performs an assessment of Janelle with the following additional findings: her uterine fundus is palpable 4 cm above the umbilicus and deviated to the right side; it is not firm; a large amount of vaginal bleeding and clots are noted saturating the obstetric pad.=What is the nursing priority in this situation?=What causes other than uterine atony could be contributing to this postpartum hemorrhage? Case Study #2 (continued)The physician evaluates Janelle and finds no lacerations and orders carboprost tromethamine 250 mcg IM (intramuscularly).=Why is this drug ordered?=What are the common side effects with the use of carboprost tromethamine? Please provide references…..Health Science Science Nursing NURSING 1412

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