This document provides a case study report of a 26-year-old pregnant woman, Sita Rai, who was admitted to the hospital with abdominal pain and diagnosed with oligohydramnios. The summary includes biographical data, obstetric history, physical examination findings, diagnosis of oligohydramnios, management including a cesarean section delivery, nursing care plan, and discharge teaching. Oligohydramnios is defined as a low amniotic fluid volume condition that can cause fetal complications. The case study objectives were to understand the condition and provide holistic nursing care to the patient.
Mrs. M, a 24-year-old pregnant woman, presented to the emergency department with abdominal cramping and heavy vaginal bleeding. Her physical exam and diagnostic tests indicated an abnormal gestational sac near her cervical canal. She was diagnosed with an inevitable abortion, where continuation of the pregnancy was not possible. For treatment of inevitable abortions before 12 weeks, options include dilation and evacuation followed by curettage or suction evacuation. After 12 weeks, options include oxytocin to accelerate uterine contractions or abdominal hysterotomy. Complications can include injury, perforation, bleeding, shock, or infection if tissue remains in the uterus.
Placenta praevia is a condition where the placenta is implanted in the lower uterine segment, either partially or completely covering the internal cervical os. There are four types depending on the degree of coverage of the cervical os. Risk factors include multiparity, increased maternal age, smoking, and history of uterine scarring. Symptoms include painless vaginal bleeding unrelated to activity. Management depends on gestational age and stability of the mother and fetus, ranging from bed rest to cesarean delivery. Nursing care focuses on monitoring for signs of decreased cardiac output or tissue perfusion due to blood loss, and providing education and support to address the mother's fears.
This topic contains Meaning and definitions of midwifery, obstetrics, obstetrical nursing, midwife, scope of midwifery, basic competencies of a midwife, history of midwifery in nursing and development of maternity services in India.
Labour is the process by which the fetus and placenta are expelled from the uterus through the birth canal. It involves involuntary uterine contractions that cause effacement and dilation of the cervix, allowing the fetus to descend and be delivered. Normal labour has three stages - the first stage involves cervical dilation, the second stage is expulsion of the fetus, and the third stage is expulsion of the placenta. Multiple factors influence the progress of labour, including the size and position of the fetus, strength of uterine contractions, and psychological state of the mother.
This document discusses polyhydramnios, or excessive amniotic fluid, during pregnancy. It defines polyhydramnios as an amniotic fluid index greater than 25 cm or a single vertical pocket over 8 cm. Common causes include fetal anomalies, placental tumors, multiple pregnancies, and maternal diabetes. Chronic polyhydramnios presents with abdominal swelling while acute cases are rarer and can be caused by twin-twin transfusion syndrome or large placental tumors. Ultrasound is used to diagnose and complications for both mother and baby must be monitored and managed.
This document summarizes guidelines for vaginal birth after cesarean (VBAC) based on recommendations from the American College of Obstetricians and Gynecologists (ACOG). It states that over 60-80% of women with one previous low transverse cesarean section can successfully have a VBAC, and lists criteria for candidates, including no prior uterine scarring or ruptures. It notes risks of VBAC like uterine rupture are low at 1% but serious, and benefits include shorter recovery over repeat cesarean. The document provides information on risks, benefits and factors to consider for VBAC.
The average fetal heart rate is between 110 and 160 beats per minute. It can vary by 5 to 25 beats per minute. The fetal heart rate may change as your baby responds to conditions in your uterus. An abnormal fetal heart rate may mean that your baby is not getting enough oxygen or that there are other problems.
Mrs. M, a 24-year-old pregnant woman, presented to the emergency department with abdominal cramping and heavy vaginal bleeding. Her physical exam and diagnostic tests indicated an abnormal gestational sac near her cervical canal. She was diagnosed with an inevitable abortion, where continuation of the pregnancy was not possible. For treatment of inevitable abortions before 12 weeks, options include dilation and evacuation followed by curettage or suction evacuation. After 12 weeks, options include oxytocin to accelerate uterine contractions or abdominal hysterotomy. Complications can include injury, perforation, bleeding, shock, or infection if tissue remains in the uterus.
Placenta praevia is a condition where the placenta is implanted in the lower uterine segment, either partially or completely covering the internal cervical os. There are four types depending on the degree of coverage of the cervical os. Risk factors include multiparity, increased maternal age, smoking, and history of uterine scarring. Symptoms include painless vaginal bleeding unrelated to activity. Management depends on gestational age and stability of the mother and fetus, ranging from bed rest to cesarean delivery. Nursing care focuses on monitoring for signs of decreased cardiac output or tissue perfusion due to blood loss, and providing education and support to address the mother's fears.
This topic contains Meaning and definitions of midwifery, obstetrics, obstetrical nursing, midwife, scope of midwifery, basic competencies of a midwife, history of midwifery in nursing and development of maternity services in India.
Labour is the process by which the fetus and placenta are expelled from the uterus through the birth canal. It involves involuntary uterine contractions that cause effacement and dilation of the cervix, allowing the fetus to descend and be delivered. Normal labour has three stages - the first stage involves cervical dilation, the second stage is expulsion of the fetus, and the third stage is expulsion of the placenta. Multiple factors influence the progress of labour, including the size and position of the fetus, strength of uterine contractions, and psychological state of the mother.
This document discusses polyhydramnios, or excessive amniotic fluid, during pregnancy. It defines polyhydramnios as an amniotic fluid index greater than 25 cm or a single vertical pocket over 8 cm. Common causes include fetal anomalies, placental tumors, multiple pregnancies, and maternal diabetes. Chronic polyhydramnios presents with abdominal swelling while acute cases are rarer and can be caused by twin-twin transfusion syndrome or large placental tumors. Ultrasound is used to diagnose and complications for both mother and baby must be monitored and managed.
This document summarizes guidelines for vaginal birth after cesarean (VBAC) based on recommendations from the American College of Obstetricians and Gynecologists (ACOG). It states that over 60-80% of women with one previous low transverse cesarean section can successfully have a VBAC, and lists criteria for candidates, including no prior uterine scarring or ruptures. It notes risks of VBAC like uterine rupture are low at 1% but serious, and benefits include shorter recovery over repeat cesarean. The document provides information on risks, benefits and factors to consider for VBAC.
The average fetal heart rate is between 110 and 160 beats per minute. It can vary by 5 to 25 beats per minute. The fetal heart rate may change as your baby responds to conditions in your uterus. An abnormal fetal heart rate may mean that your baby is not getting enough oxygen or that there are other problems.
Mrs. Vasanthamma, a 30-year old housewife, presented with 8 months of amenorrhea and easy fatigability for the past 2 months. On examination, she was found to be anemic with a hemoglobin level of 8.4 gm%. She was diagnosed with anemia during her current pregnancy. A full obstetric examination estimated her gestational age at 32 weeks with a fetal weight of approximately 2.48 kg in the breech position.
This document discusses the relationship between the fetus and the pelvis during childbirth. It describes the lie or orientation of the fetus, the presenting part of the fetus that engages the pelvis, and the position and attitude of the fetal head. The key points are:
- The fetus most commonly lies longitudinally in the uterus with the head engaging the pelvis (cephalic presentation).
- The position describes the location of the presenting part, such as the occiput, in relation to maternal pelvic quadrants.
- The attitude refers to the flexion or extension of fetal parts. Flexion is most common with the head flexed forward onto the chest.
- Moulding, or shifting of fetal
Breastfeeding provides optimal nutrition for infants and benefits both mother and baby. It involves the feeding of an infant with breast milk from the female breast. Breast milk is produced when suckling stimulates the release of prolactin and oxytocin, which causes milk production and ejection from the alveoli into ducts. Breast milk contains proteins, fats, carbohydrates, vitamins, and minerals essential for infant growth and development as well as protection from disease. Proper positioning and latch are important to establish successful breastfeeding and adequate milk production.
This document discusses abnormal labor and its management. It defines normal labor and describes abnormal labor as a difficult labor pattern that deviates from typical progression. Abnormal labor can be caused by issues with the cervix, uterus, maternal pelvis, or fetus. It further outlines the stages of labor and describes factors that can contribute to prolonged latent phase, dysfunctional labor, and dystocia. The management of abnormal labor may include amniotomy, oxytocin administration, operative vaginal delivery, or cesarean section depending on the specific issues present and labor progression. Close monitoring of labor and timely interventions are important to properly manage abnormal labor.
This document provides information on various fetal assessment measures that can be performed during pregnancy. It discusses evaluating fetal growth through fundal height measurements and Leopold's maneuvers. It also describes biochemical tests that can be done including maternal serum alpha-fetoprotein, triple screen, estriol levels, and acetylcholine esterase. Invasive procedures for assessing the fetus such as amniocentesis and chorionic villus sampling are explained. The aims, indications, procedures, and risks of these various fetal monitoring techniques are outlined in the document.
1) The document presents a case study on breech presentation. It includes the patient's bio-demographic data, history, physical examination findings, diagnosis of G3P0L2A1 at 37+2 weeks gestation with breech presentation, and management.
2) The objectives, rationale for selecting this case, and details of breech presentation such as types, risk factors, etiology, and diagnosis are discussed.
3) Nursing care was provided using the nursing process to address the patient's needs and problems in order to reduce illness and support the patient and family.
This document outlines the protocol for antenatal clinic visits. It recommends that pregnant women have at least 4 checkups - in the first, second, and third trimesters and between 36 weeks and term. The first visit includes registration, history taking, examinations, and basic investigations. Subsequent visits monitor weight, blood pressure, fetal growth and position. Investigations are repeated as needed. The protocol advises on nutrition, rest, medication, symptoms to report, and maternal risk factors identified during antenatal care.
The document discusses the relationship of the fetus to the uterus and pelvis during pregnancy and birth. It defines lie, presentation, presenting part, position, attitude, and denominator. The lie refers to the orientation of the fetus, which is usually longitudinal but can also be transverse or oblique. The presentation is the part of the fetus occupying the lower uterus, most commonly the head (cephalic) but also the breech or shoulders. The presenting part is the portion overlying the internal os. Position refers to the relationship between the denominator (occiput, sacrum, etc.) and maternal pelvis quadrants. Attitude describes the flexion of fetal parts. Common presentations, positions, attitudes, and denominators are defined in
This ppt is made by Mr. arkab khan pathan under guidance of Mrs. RAKHI GOAR. this ppt contain the detail and all the lecture notes of HEG.
THANK YOU.
Arkab khan
Case study on Esophageal Atresia with Tracheo esophageal Fistulapabitra sharma
This case study examines a 4-day-old female infant diagnosed with esophageal atresia with tracheo-esophageal fistula (EA/TEF) who was admitted to the surgical intensive care unit of Kanti Children's Hospital. The infant presented with excessive salivation, cyanosis after feeding, and difficulty breathing. Physical examination revealed decreased weight, dry skin, and abdominal distension. The patient was diagnosed with Type C EA/TEF, the most common type involving a blind proximal esophagus connected to the trachea by a fistula. Treatment involved surgical repair of the defect. The case study aims to provide a comprehensive overview of the patient's condition, including disease background, clinical presentation, management, and
Antenatal care involves planned examinations and observations of a woman from conception through birth. Effective antenatal care can help reduce risks to both mother and infant through early and regular checkups. The goals of antenatal care are to reduce maternal and infant mortality and morbidity rates by preventing, identifying, and treating any maternal or fetal issues that could impact the pregnancy outcome. Key components of antenatal care include medical history, physical examination, laboratory tests, health education, and monitoring for danger signs throughout the pregnancy.
This document discusses hyperemesis gravidarum, a severe form of vomiting during pregnancy. It defines hyperemesis gravidarum as excessive vomiting that negatively impacts a pregnant woman's health and daily activities. Risk factors include young or older age, being pregnant with multiples, obesity, and unwanted pregnancy. Treatment involves hospitalization, IV fluids to correct dehydration and electrolyte imbalances, antiemetic drugs, and nutritional supplementation. Nursing care focuses on monitoring for signs of improvement and complications while encouraging small, frequent meals once vomiting is controlled.
This document discusses various abnormalities that can occur during labour and delivery, categorized as abnormalities of the power (uterine contractility), abnormalities involving the passenger (fetus), or abnormalities of the passage (pelvis). It provides details on specific issues like uterine dysfunction, fetopelvic disproportion, abnormal fetal presentations (breech, transverse lie), prolapsed umbilical cord, and shoulder dystocia. Management strategies are discussed for each abnormality, including oxytocin use, operative vaginal delivery, and Caesarean section when appropriate. The goal is to identify abnormalities early to guide management and prevent adverse maternal-fetal outcomes from difficult labor.
An obstetric examination involves inspecting, palpating, and auscultating a pregnant patient's abdomen. The examiner should ensure patient privacy and comfort, explain the exam, and obtain consent. By palpating the abdomen, the examiner can determine the fundal height, fetal lie, presentation, position, and engagement as well as the fetal heart rate. An accurate exam requires practice and experience, and abnormal findings may require ultrasound confirmation.
Mrs. Paridhi, a 29-year-old housewife, was admitted to the hospital with complaints of vaginal bleeding at 32 weeks of pregnancy. She was diagnosed with placenta previa. Her care included intravenous fluids, monitoring of bleeding, and administration of medications as ordered by the doctor. After 1 day of care, her health improved as the bleeding reduced. She was indicated for a cesarean delivery to terminate the pregnancy due to the placenta previa diagnosis.
This document provides guidance on examining and caring for mothers' breasts and nipples during breastfeeding. It discusses examining the breasts for issues like engorgement or surgery scars. It also covers managing common problems like sore or cracked nipples, flat or inverted nipples, blocked ducts, mastitis, breast abscesses, and candida infections. The document emphasizes building mothers' confidence, ensuring proper latching positions, frequent feeding to remove milk and prevent infections, and treating any issues to support ongoing breastfeeding.
This document summarizes an obstetric case of a 30-year-old pregnant woman. She presents with amenorrhea and easy fatigability for the past 2 months. Her medical history and examination reveal she is anemic, with a hemoglobin level of 7.4g/dl. She has two previous normal deliveries. A diagnosis of anemia is made based on her symptoms and laboratory results.
Antenatal care /objectives/history collection abdominal examinationBabitha Mathew
Antenatal care is the care you get from healthcare professionals to ensure you have a healthy pregnancy. It includes information on services and support to make choices right for you. Antenatal care will include regular appointments with a midwife, ultrasound scans and screening tests for you and your baby.
An obstetric physical examination involves a full examination of the pregnant woman, including abdominal and pelvic examinations. The abdominal examination assesses the size, shape, and position of the uterus to determine information like fetal presentation, position, and lie. The pelvic examination allows assessment of cervical dilation, effacement, and fetal station and engagement. Together these examinations provide important information about the fetus and progress of the pregnancy or labor.
The document describes fetal development from conception through 40 weeks of gestation. It is broken into 3 periods: pre-embryonic (weeks 1-2), embryonic (weeks 3-8), and fetal (week 9-birth). Key developments include: formation of major organ systems by 8 weeks; spontaneous movements beginning at 12 weeks; lanugo hair and nails developing at 16-20 weeks; ability to hear at 24 weeks; and lungs maturing to allow breathing outside womb starting at 28 weeks. The fetus continues growing and developing through week 40.
Chapter 8 nursing care during labor and pain managementLeonila Limpio
This chapter discusses nursing care during labor and pain management. It covers cultural considerations during labor, different birth settings including hospital, birthing centers, and home births. It describes the stages of labor and nursing assessments and interventions during each stage. Nonpharmacological and pharmacological pain management strategies are discussed. The chapter objectives are to describe nursing care during labor including assessments, interventions, pain management and immediate newborn care.
The document provides information about various eye, throat, and immune system problems, as well as musculoskeletal problems. For each system, specific disorders are enumerated and described. One problem from each system is then selected and a nursing care plan is provided using the nursing diagnosis, objectives of care, nursing interventions, and rationale format. The care plan example provided is for a patient with glaucoma involving the eyes, pharyngitis involving the throat, lupus erythematosus involving the immune system, and a herniated disk involving the musculoskeletal system.
Mrs. Vasanthamma, a 30-year old housewife, presented with 8 months of amenorrhea and easy fatigability for the past 2 months. On examination, she was found to be anemic with a hemoglobin level of 8.4 gm%. She was diagnosed with anemia during her current pregnancy. A full obstetric examination estimated her gestational age at 32 weeks with a fetal weight of approximately 2.48 kg in the breech position.
This document discusses the relationship between the fetus and the pelvis during childbirth. It describes the lie or orientation of the fetus, the presenting part of the fetus that engages the pelvis, and the position and attitude of the fetal head. The key points are:
- The fetus most commonly lies longitudinally in the uterus with the head engaging the pelvis (cephalic presentation).
- The position describes the location of the presenting part, such as the occiput, in relation to maternal pelvic quadrants.
- The attitude refers to the flexion or extension of fetal parts. Flexion is most common with the head flexed forward onto the chest.
- Moulding, or shifting of fetal
Breastfeeding provides optimal nutrition for infants and benefits both mother and baby. It involves the feeding of an infant with breast milk from the female breast. Breast milk is produced when suckling stimulates the release of prolactin and oxytocin, which causes milk production and ejection from the alveoli into ducts. Breast milk contains proteins, fats, carbohydrates, vitamins, and minerals essential for infant growth and development as well as protection from disease. Proper positioning and latch are important to establish successful breastfeeding and adequate milk production.
This document discusses abnormal labor and its management. It defines normal labor and describes abnormal labor as a difficult labor pattern that deviates from typical progression. Abnormal labor can be caused by issues with the cervix, uterus, maternal pelvis, or fetus. It further outlines the stages of labor and describes factors that can contribute to prolonged latent phase, dysfunctional labor, and dystocia. The management of abnormal labor may include amniotomy, oxytocin administration, operative vaginal delivery, or cesarean section depending on the specific issues present and labor progression. Close monitoring of labor and timely interventions are important to properly manage abnormal labor.
This document provides information on various fetal assessment measures that can be performed during pregnancy. It discusses evaluating fetal growth through fundal height measurements and Leopold's maneuvers. It also describes biochemical tests that can be done including maternal serum alpha-fetoprotein, triple screen, estriol levels, and acetylcholine esterase. Invasive procedures for assessing the fetus such as amniocentesis and chorionic villus sampling are explained. The aims, indications, procedures, and risks of these various fetal monitoring techniques are outlined in the document.
1) The document presents a case study on breech presentation. It includes the patient's bio-demographic data, history, physical examination findings, diagnosis of G3P0L2A1 at 37+2 weeks gestation with breech presentation, and management.
2) The objectives, rationale for selecting this case, and details of breech presentation such as types, risk factors, etiology, and diagnosis are discussed.
3) Nursing care was provided using the nursing process to address the patient's needs and problems in order to reduce illness and support the patient and family.
This document outlines the protocol for antenatal clinic visits. It recommends that pregnant women have at least 4 checkups - in the first, second, and third trimesters and between 36 weeks and term. The first visit includes registration, history taking, examinations, and basic investigations. Subsequent visits monitor weight, blood pressure, fetal growth and position. Investigations are repeated as needed. The protocol advises on nutrition, rest, medication, symptoms to report, and maternal risk factors identified during antenatal care.
The document discusses the relationship of the fetus to the uterus and pelvis during pregnancy and birth. It defines lie, presentation, presenting part, position, attitude, and denominator. The lie refers to the orientation of the fetus, which is usually longitudinal but can also be transverse or oblique. The presentation is the part of the fetus occupying the lower uterus, most commonly the head (cephalic) but also the breech or shoulders. The presenting part is the portion overlying the internal os. Position refers to the relationship between the denominator (occiput, sacrum, etc.) and maternal pelvis quadrants. Attitude describes the flexion of fetal parts. Common presentations, positions, attitudes, and denominators are defined in
This ppt is made by Mr. arkab khan pathan under guidance of Mrs. RAKHI GOAR. this ppt contain the detail and all the lecture notes of HEG.
THANK YOU.
Arkab khan
Case study on Esophageal Atresia with Tracheo esophageal Fistulapabitra sharma
This case study examines a 4-day-old female infant diagnosed with esophageal atresia with tracheo-esophageal fistula (EA/TEF) who was admitted to the surgical intensive care unit of Kanti Children's Hospital. The infant presented with excessive salivation, cyanosis after feeding, and difficulty breathing. Physical examination revealed decreased weight, dry skin, and abdominal distension. The patient was diagnosed with Type C EA/TEF, the most common type involving a blind proximal esophagus connected to the trachea by a fistula. Treatment involved surgical repair of the defect. The case study aims to provide a comprehensive overview of the patient's condition, including disease background, clinical presentation, management, and
Antenatal care involves planned examinations and observations of a woman from conception through birth. Effective antenatal care can help reduce risks to both mother and infant through early and regular checkups. The goals of antenatal care are to reduce maternal and infant mortality and morbidity rates by preventing, identifying, and treating any maternal or fetal issues that could impact the pregnancy outcome. Key components of antenatal care include medical history, physical examination, laboratory tests, health education, and monitoring for danger signs throughout the pregnancy.
This document discusses hyperemesis gravidarum, a severe form of vomiting during pregnancy. It defines hyperemesis gravidarum as excessive vomiting that negatively impacts a pregnant woman's health and daily activities. Risk factors include young or older age, being pregnant with multiples, obesity, and unwanted pregnancy. Treatment involves hospitalization, IV fluids to correct dehydration and electrolyte imbalances, antiemetic drugs, and nutritional supplementation. Nursing care focuses on monitoring for signs of improvement and complications while encouraging small, frequent meals once vomiting is controlled.
This document discusses various abnormalities that can occur during labour and delivery, categorized as abnormalities of the power (uterine contractility), abnormalities involving the passenger (fetus), or abnormalities of the passage (pelvis). It provides details on specific issues like uterine dysfunction, fetopelvic disproportion, abnormal fetal presentations (breech, transverse lie), prolapsed umbilical cord, and shoulder dystocia. Management strategies are discussed for each abnormality, including oxytocin use, operative vaginal delivery, and Caesarean section when appropriate. The goal is to identify abnormalities early to guide management and prevent adverse maternal-fetal outcomes from difficult labor.
An obstetric examination involves inspecting, palpating, and auscultating a pregnant patient's abdomen. The examiner should ensure patient privacy and comfort, explain the exam, and obtain consent. By palpating the abdomen, the examiner can determine the fundal height, fetal lie, presentation, position, and engagement as well as the fetal heart rate. An accurate exam requires practice and experience, and abnormal findings may require ultrasound confirmation.
Mrs. Paridhi, a 29-year-old housewife, was admitted to the hospital with complaints of vaginal bleeding at 32 weeks of pregnancy. She was diagnosed with placenta previa. Her care included intravenous fluids, monitoring of bleeding, and administration of medications as ordered by the doctor. After 1 day of care, her health improved as the bleeding reduced. She was indicated for a cesarean delivery to terminate the pregnancy due to the placenta previa diagnosis.
This document provides guidance on examining and caring for mothers' breasts and nipples during breastfeeding. It discusses examining the breasts for issues like engorgement or surgery scars. It also covers managing common problems like sore or cracked nipples, flat or inverted nipples, blocked ducts, mastitis, breast abscesses, and candida infections. The document emphasizes building mothers' confidence, ensuring proper latching positions, frequent feeding to remove milk and prevent infections, and treating any issues to support ongoing breastfeeding.
This document summarizes an obstetric case of a 30-year-old pregnant woman. She presents with amenorrhea and easy fatigability for the past 2 months. Her medical history and examination reveal she is anemic, with a hemoglobin level of 7.4g/dl. She has two previous normal deliveries. A diagnosis of anemia is made based on her symptoms and laboratory results.
Antenatal care /objectives/history collection abdominal examinationBabitha Mathew
Antenatal care is the care you get from healthcare professionals to ensure you have a healthy pregnancy. It includes information on services and support to make choices right for you. Antenatal care will include regular appointments with a midwife, ultrasound scans and screening tests for you and your baby.
An obstetric physical examination involves a full examination of the pregnant woman, including abdominal and pelvic examinations. The abdominal examination assesses the size, shape, and position of the uterus to determine information like fetal presentation, position, and lie. The pelvic examination allows assessment of cervical dilation, effacement, and fetal station and engagement. Together these examinations provide important information about the fetus and progress of the pregnancy or labor.
The document describes fetal development from conception through 40 weeks of gestation. It is broken into 3 periods: pre-embryonic (weeks 1-2), embryonic (weeks 3-8), and fetal (week 9-birth). Key developments include: formation of major organ systems by 8 weeks; spontaneous movements beginning at 12 weeks; lanugo hair and nails developing at 16-20 weeks; ability to hear at 24 weeks; and lungs maturing to allow breathing outside womb starting at 28 weeks. The fetus continues growing and developing through week 40.
Chapter 8 nursing care during labor and pain managementLeonila Limpio
This chapter discusses nursing care during labor and pain management. It covers cultural considerations during labor, different birth settings including hospital, birthing centers, and home births. It describes the stages of labor and nursing assessments and interventions during each stage. Nonpharmacological and pharmacological pain management strategies are discussed. The chapter objectives are to describe nursing care during labor including assessments, interventions, pain management and immediate newborn care.
The document provides information about various eye, throat, and immune system problems, as well as musculoskeletal problems. For each system, specific disorders are enumerated and described. One problem from each system is then selected and a nursing care plan is provided using the nursing diagnosis, objectives of care, nursing interventions, and rationale format. The care plan example provided is for a patient with glaucoma involving the eyes, pharyngitis involving the throat, lupus erythematosus involving the immune system, and a herniated disk involving the musculoskeletal system.
This document describes a DNA fingerprinting activity to determine which baby belongs to which parents. Three babies and three sets of parents had their DNA fingerprinted. By comparing the bands of each parent to each baby, it can be determined which bands each baby inherited from its mother and father. This allows one to identify which baby belongs to each set of parents. The analysis finds that Baby 3 belongs to Couple A, Baby 1 belongs to Couple B, and Baby 2 belongs to Couple C.
The document discusses preeclampsia, including its signs, symptoms, risk factors, diagnostic tests, pathophysiology, and treatment. Preeclampsia is a pregnancy complication characterized by high blood pressure and signs of damage to other organ systems. It is caused by abnormal development of the placenta leading to reduced blood flow and endothelial cell dysfunction systemically. Proper management involves monitoring blood pressure, delivering the baby to resolve symptoms, and potentially using antihypertensive medications.
The document outlines objectives for both nurse-centered and patient-centered care of a patient with hypertension. The nurse-centered objectives focus on familiarizing with the role of the nurse in caring for hypertension patients and enhancing nursing skills. The patient-centered objectives aim to help the patient gain trust in the student nurse, feel comfortable, improve her condition, cooperate with management, practice proper hygiene, accept her condition, and learn about complications and treatment.
1. Respiratory disorders discussed include foreign body aspiration, croup syndromes like laryngotracheobronchitis and epiglottitis, bacterial tracheitis, bronchiolitis, asthma, cystic fibrosis, pharyngitis, otitis media, and otitis media with effusion.
2. Nursing interventions focus on maintaining airway patency, meeting fluid and nutritional needs, providing respiratory therapies, administering medications, supporting psychosocial needs, providing discharge teaching, and managing chronic conditions in the home setting.
3. Manifestations vary based on the specific respiratory disorder but may include dysphonia, wheezing, cough, stridor, retractions,
Nursing crib.com nursing care plan potts diseaserobin kurian
The patient reported back pain. A physical assessment revealed facial pain expressions, fatigue, and normal vital signs. The diagnosis is Pott's disease, a form of spinal tuberculosis causing back pain and stiffness. The nursing care plan includes applying warm compresses, gentle massage, encouraging position changes and stress management to reduce pain and fatigue. Medications of antibiotics and anti-inflammatories will also be administered.
This document provides background information on the Crisostomo family that is the subject of a family nursing diagnosis study. It introduces the family structure, which consists of an elderly widow, Angelita Policarpio, living with her daughter Irma Crisostomo and son-in-law George Crisostomo. It then discusses the socioeconomic factors of the family, including their education, occupations, income, religion and environmental living conditions. Finally, it provides a health assessment of family member Angelita Policarpio, outlining her medical history of kidney stones, arthritis, hypertension and current medications. The document lays out the initial data collected on the Crisostomo family to inform the family nursing diagnosis and care plan.
The document discusses respiratory disorders and provides an overview of respiratory system functions. It describes the objectives of nursing care for clients with respiratory conditions like COPD. It then provides a case study of a 62-year-old female client named Mrs. Lakshmi who was admitted with COPD. Her medical history, physical assessment, vital signs and diagnostic profile are documented. The summary focuses on key details about the client and her respiratory condition.
Mohamed Anwer Naleef, I am Nurse at Hemas Hospital,
This is about care of patient with Cirrhosis Disease Condition. As a Nurse three days my Nursing Process, observation, Nursing care Plan, Nursing Care and Help to patient manage and adjust the disease condition. Because the Cirrhosis is majority of male patients are facing the srilanka due to Alcohol. Even developing countries people also facing this problem due to uncontrolled Alcohol Consumption.
In my Case Studies, I briefly explained about Liver Alcoholic Cirrhosis, Treatment Complaience , medical management, Nursing Care, Nursing assessment, Nursing diagnosis, Nursing Planning, Nursing Intervention, Health Education for a Patient when patient Discharge.
The document provides information about neonatal sepsis, including:
- Neonatal sepsis is a leading cause of death for newborns, especially premature infants, due to their underdeveloped immune systems. It can be caused by bacteria passing from the mother during or after birth.
- Symptoms of neonatal sepsis include fever, poor feeding, jaundice, and respiratory distress. Prompt diagnosis and treatment are important to prevent disability or death.
- The case study focuses on a 3-day old infant admitted with a diagnosis of neonatal sepsis. Nursing assessments and care plans are developed to properly treat the condition.
This document provides information about umbilical cord presentation and prolapse from Dr. Suresh Babu Chaduvula, a professor in obstetrics and gynecology. It defines occult and overt umbilical cord prolapse, risk factors, signs and symptoms, management strategies, and neonatal outcomes. Predisposing factors include primigravidas, breech presentations, and contracted pelvises. Prompt diagnosis and emergency procedures like cesarean delivery are important to reduce the risk of hypoxic injury and mortality, which can be as high as 50% without swift intervention.
The nursing care plan addresses a patient experiencing renal failure who presents with edema, fatigue, and weakness, and notes an assessment of fluid overload and compromised renal function. The plan includes monitoring intake and output, daily weighing, skin assessments for edema, oral fluid replacement within restrictions, and administering diuretics and antihypertensives as needed to manage fluid levels, reduce edema, and treat hypertension. The expected outcomes are appropriate urinary output, stable weight and vital signs, and resolution of edema.
Nursing care plans, concept map bronhial asthmaReynel Dan
This nursing care plan addresses a 14-year-old female patient named Crystal Clear presenting with difficulty breathing and diagnosed with bronchial asthma. The plan identifies 6 problems related to ineffective airway clearance, ineffective breathing pattern, impaired gas exchange, impaired cardiopulmonary tissue perfusion, fatigue, and self-care deficit. For each problem, the plan outlines short-term and long-term objectives, interventions, rationales, and evaluations. Interventions include respiratory treatments, medication administration, oxygen supplementation, and patient/family education. The overall goal is for the patient to maintain a clear airway and normal breathing pattern while preventing potential complications.
Nursing Case study nsvd normal spontaneous deliverypinoy nurze
The document provides details about a case of normal spontaneous vaginal delivery (NSVD). It describes the four stages of labor: stage 1 involves cervical dilation from 0-10 cm over 3 phases; stage 2 is the pushing stage until the baby is delivered; stage 3 involves delivery of the placenta; and stage 4 is the recovery period. It then provides a nursing case study of a 15-year old patient who experienced an unwanted pregnancy from rape and underwent NSVD, including assessments, orders, and progression of labor and recovery.
1. Intrauterine growth restriction (IUGR) refers to fetuses that are small for gestational age and display signs of chronic hypoxia or failure to thrive. It occurs in approximately 3-5% of pregnancies.
2. IUGR can be classified as symmetrical/intrinsic or asymmetrical based on whether growth restriction affects all parameters equally or causes brain sparing. The causes include placental insufficiency, infections, genetic and structural fetal anomalies, and various maternal medical conditions and lifestyle factors.
3. Complications of IUGR include perinatal mortality and morbidity as well as long term risks of metabolic and cardiovascular diseases. Diagnosis involves identifying high risk mothers, accurate dating by ultrasound,
Application of theory to nursing practiceArun Madanan
Here is an analysis of this case using Neuman's Systems Model:
- Janice's normal line of defense was weakened by the stress of moving and adjusting to a new environment and job.
- Her flexible line of defense was also impacted as she had difficulty coping with stressors like an unsupportive work environment and missing her social support network.
- This left her vulnerable to stressors penetrating her lines of defense and affecting her normal stable state, resulting in symptoms of anxiety and depression.
- Nursing interventions could aim to strengthen her normal and flexible lines of defense, such as providing social support, stress management techniques, and assertiveness training to better cope with workplace issues.
- The goal would be to help
The document provides information and guidance to nursing students on how to write a care plan, including defining the different components such as nursing diagnosis, goals, interventions, and evaluation. It explains each section in detail and provides examples. Resources are also included to help students understand and complete their care plan assignments.
This document provides information about a case study presentation on cardiomyopathy. It includes the objectives of the case study, the rationale for selecting cardiomyopathy, and the patient's biographical information and medical history. The methodology used to produce the report is also described. The patient, a 67-year-old female, presented with shortness of breath and pedal edema. Her medical history and examination findings are detailed. The developmental tasks of older adults are discussed in relation to the patient. Cardiomyopathy is then defined as a heart muscle disease associated with cardiac dysfunction that is not the result of other cardiac abnormalities.
The document provides a nursing care plan for a 62-year-old female patient, Mrs. Kulsum, who is being treated for Pott's Spine at L3 and L4 levels. It includes her medical history, physical examination findings, lab results, medications and nursing assessments. The nursing diagnoses identified are acute pain, impaired mobility, altered nutrition, impaired skin integrity, self-care deficit, ineffective coping and risks for infection and aspiration due to her condition and restricted activity.
My sources of hope, strength, comfort and peace come from my faith in God. I find solace in prayer and reading scriptures. Knowing that God is in control of my life and health situation gives me comfort. My family also gives me strength, hope and peace. Their love and support helps me get through each day.
What are your cultural/spiritual beliefs and practices that are important to your well-being?
My cultural/spiritual beliefs that are important to my well-being are:
- Faith in God: I am a Pentecostal Christian. My faith and belief that God is sovereign over all aspects of my life, including my health is very important. It gives me hope
3 history taking & physical examinationawadfadlalla1
This document provides information on nursing history taking and physical examination. It discusses the importance of obtaining an accurate patient history, which is critical for diagnosis. The key components of history taking are identified as demographic data, chief complaint, history of present illness, past medical history, family history, drug history, review of systems, and physical examination. The principles and techniques of physical examination are outlined, including inspection, palpation, percussion, and auscultation. A head-to-toe assessment approach is recommended to perform a thorough physical exam.
1. T.Z.S.H is a 1 year and 2 month old female admitted to the hospital complaining of severe cough, fever, and runny nose for two days.
2. Her immunizations are up to date and her development appears normal for her age. She enjoys playing with dolls and watching TV.
3. On examination, she appears well but has wheezing and a runny nose. Her vital signs and physical exam are otherwise normal. She is diagnosed with bronchitis.
This case study describes 49-year-old Mr. Dhatchanamoorthy who presented with fever, cough, vomiting and breathlessness. He was diagnosed with pulmonary tuberculosis and a history of diabetes. He lives in a nuclear family in a rural village in a house with adequate ventilation and sanitation. Medical examination found him moderately nourished with signs of left lung consolidation. Sputum examination confirmed active tuberculosis bacteria. He was started on antitubercular treatment and advised on nutrition, hygiene and follow-up to support his recovery.
The document contains a community health nursing case study report submitted by a nursing student. It summarizes the health assessment, medical history, physical examination, care plan and evaluation of a 37-year-old female client named Mrs. Rakhi Sinde. The client has been experiencing gas problems, anemia, weakness and joint pain. The nursing student assessed the client's general condition, mobility, nutritional levels and risks. A care plan was implemented to maintain nutrition, remove joint pain and anemia. The evaluation found the client's health, nutrition and mobility improved as anemia and joint pain decreased.
The document discusses a case study of a 24-year-old female patient named Kalpana Pandit who was admitted to the hospital for cholelithiasis (gallstones). It provides details of her medical history, symptoms, physical examination findings, diagnosis, and treatment plan. The causes and risk factors for cholelithiasis are also briefly explained.
1. The patient is a 40-year-old male diagnosed with esophageal carcinoma based on biopsy findings. He presents with symptoms of difficulty swallowing, nausea, vomiting, and chest pain.
2. Physical examination reveals pallor and fatigue. Investigations show abnormal biopsy findings and signs of esophageal carcinoma.
3. Treatment options include esophagectomy, palliative stenting, laser therapy, or photodynamic therapy depending on the stage and type of cancer. The goal is to relieve symptoms and improve quality of life.
The document summarizes Kara Simon's experience in the St. Gianna Health Academy program, including rotations in different medical units, opportunities to observe medical procedures, classes taken for college credit, presentations given at schools, and certification received in CPR. The experience increased her interest in a medical career and prepared her for college and future employment in the medical field.
1. The document summarizes a case presentation on a 32-year-old female patient admitted for abnormal uterine bleeding secondary to prolapsed submucosal myoma.
2. It includes the patient's medical history, physical assessment findings, diagnosis, treatment plan including a vaginal myomectomy, and nursing care plan.
3. The case presentation follows a specific format covering the patient's data, health history, physical assessment, definition of the disease, pathophysiology, diagnostic procedures, medical management, nursing diagnosis, and discharge plan.
This document provides information and guidance for fourth year medical students. It outlines the curriculum, which focuses on clinical pathology and developing professional skills. Students are encouraged to think and behave like doctors, with a focus on treating patients. Success is said to involve integrating basic science, pathology and clinical knowledge. Attendance is compulsory and students must meet requirements to be eligible for exams.
1. The document presents a case study of a 74-year-old male patient diagnosed with Parkinson's disease. It includes details on the patient's history, examination findings, and management.
2. The objectives of the case study were to share knowledge with supervisors, get feedback, and improve presentation skills. Parkinson's disease causes abnormal movements and difficulties with walking.
3. Examination revealed symptoms of Parkinson's disease including a shuffling gait, masked facial expressions, tremors, and rigidity.
This document provides an outline for a course on gynecology for midwives. It includes an introduction to gynecology and outlines approaches for assessing patients, including history taking and physical examination. The history taking section describes obtaining information on a patient's identity, chief complaint, medical history, menstrual history, sexual history, and other relevant details. The physical examination section explains how to conduct breast, abdominal, and pelvic exams. It describes examining the external genitalia, inserting a speculum to examine the cervix, and performing bimanual and rectovaginal exams as part of the pelvic exam. The document aims to equip midwives with the clinical skills and knowledge needed to effectively care for female patients.
This document discusses the Tribal Health Initiative in Sittilingi, Tamil Nadu, India. [1] It trains local tribal women as para-medical workers to provide healthcare services in their remote communities that previously lacked modern facilities. [2] The health workers manage most hospital operations, conduct deliveries, assist with surgeries, and provide community healthcare, leading to significant improvements in health outcomes. [3] The initiative challenges the myth that formal education is necessary for healthcare by empowering tribal women to heal their own people.
The 85-year-old male patient presented with progressive forgetfulness, weight loss, and depressed mood over the past year since his wife's death. His daughter observed a decline in his ability to recall recent events, directions, and names. Alzheimer's disease is the primary consideration given his age and symptoms consistent with typical memory loss and cognitive decline seen in Alzheimer's. Differential diagnoses considered include delirium, depression, and hypothyroidism but were deemed less likely based on aspects of his history and presentation that did not fully match these conditions.
This document provides a summary of GAIL (India) Limited, including its vision, mission, objectives, and key business areas. It discusses GAIL's natural gas marketing and transmission activities through its extensive pipeline network. It also summarizes GAIL's involvement in other businesses like petrochemicals, liquefied natural gas, city gas distribution, power generation, and exploration and production. The document reviews GAIL's approach and methodology for analyzing its existing marketing practices and strategies. It provides an overview of GAIL's customers, contracts, and competition in the Indian natural gas market.
JDR, a 22-year-old male college student, was referred for psychological evaluation due to obsessive behaviors around cleanliness and orderliness. Testing confirmed he has above average intelligence and obsessive compulsive disorder. Specifically, he experiences severe distress when things are not clean, organized or properly aligned. His rituals interfere with daily activities and social relationships. It is believed his OCD developed from trauma experienced from his strict father. Treatment involving exposure response prevention therapy is recommended to help reduce his compulsions and anxiety.
This document provides an overview and analysis of how emergencies impact federal systems of government based on a study of various constitutions. It begins with an introduction to federalism and discusses how war powers expand during times of emergency. It then analyzes the impact of external emergencies on federal structures in the US, India, and other countries. In India, the constitution allows for a proclamation of emergency that temporarily centralizes power in the union government and erodes state powers. The document aims to compare how different constitutions balance federalism during emergencies.
This document is the summary of a court case regarding a petition filed by Jose A. Angara seeking a writ of prohibition to prevent the Electoral Commission from considering a protest filed against his election as a member of the National Assembly. The key details are:
1) Jose A. Angara and Pedro Ynsua were candidates for the position and Angara was proclaimed the winner.
2) On December 3rd, the National Assembly passed a resolution confirming the elections of representatives where no protests were filed.
3) On December 8th, Pedro Ynsua filed a protest against Angara's election, which was the only protest filed after the resolution.
4) Angara argued the protest was
This document is a summary of a court case regarding a land registration dispute between Flordeliza and Honorio Valisno (petitioners) and Vicencio Cayaba (private respondent). The petitioners opposed Cayaba's application to register title to the land in question. The lower court dismissed the opposition based on res judicata, citing a previous court decision in favor of Cayaba. The petitioners appealed, arguing the lower court erred in several ways. The key issues discussed are whether res judicata can be invoked in a land registration case, and whether the elements of res judicata are met based on the previous court decision.
1) In the case of PT&T vs. Grace de Guzman, the Supreme Court ruled that PT&T's policy of not hiring married women was invalid and discriminatory, and that Grace's dismissal based on this policy was illegal.
2) In Estrada vs. Escritor, the Supreme Court ruled that Escritor could not be penalized for living with her partner without marriage, as her religious beliefs as a Jehovah's Witness allowed such arrangements.
3) In Balogbog vs. CA, the Supreme Court upheld the legitimacy of private respondents as the children of Gavino, even though there was no marriage certificate, as testimonial evidence proved Gav
Open Channel Flow: fluid flow with a free surfaceIndrajeet sahu
Open Channel Flow: This topic focuses on fluid flow with a free surface, such as in rivers, canals, and drainage ditches. Key concepts include the classification of flow types (steady vs. unsteady, uniform vs. non-uniform), hydraulic radius, flow resistance, Manning's equation, critical flow conditions, and energy and momentum principles. It also covers flow measurement techniques, gradually varied flow analysis, and the design of open channels. Understanding these principles is vital for effective water resource management and engineering applications.
Accident detection system project report.pdfKamal Acharya
The Rapid growth of technology and infrastructure has made our lives easier. The
advent of technology has also increased the traffic hazards and the road accidents take place
frequently which causes huge loss of life and property because of the poor emergency facilities.
Many lives could have been saved if emergency service could get accident information and
reach in time. Our project will provide an optimum solution to this draw back. A piezo electric
sensor can be used as a crash or rollover detector of the vehicle during and after a crash. With
signals from a piezo electric sensor, a severe accident can be recognized. According to this
project when a vehicle meets with an accident immediately piezo electric sensor will detect the
signal or if a car rolls over. Then with the help of GSM module and GPS module, the location
will be sent to the emergency contact. Then after conforming the location necessary action will
be taken. If the person meets with a small accident or if there is no serious threat to anyone’s
life, then the alert message can be terminated by the driver by a switch provided in order to
avoid wasting the valuable time of the medical rescue team.
Impartiality as per ISO /IEC 17025:2017 StandardMuhammadJazib15
This document provides basic guidelines for imparitallity requirement of ISO 17025. It defines in detial how it is met and wiudhwdih jdhsjdhwudjwkdbjwkdddddddddddkkkkkkkkkkkkkkkkkkkkkkkwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwioiiiiiiiiiiiii uwwwwwwwwwwwwwwwwhe wiqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqq gbbbbbbbbbbbbb owdjjjjjjjjjjjjjjjjjjjj widhi owqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqq uwdhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhwqiiiiiiiiiiiiiiiiiiiiiiiiiiiiw0pooooojjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjj whhhhhhhhhhh wheeeeeeee wihieiiiiii wihe
e qqqqqqqqqqeuwiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiqw dddddddddd cccccccccccccccv s w c r
cdf cb bicbsad ishd d qwkbdwiur e wetwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwww w
dddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddfffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffw
uuuuhhhhhhhhhhhhhhhhhhhhhhhhe qiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii iqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqq eeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeee qqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqqccccccccccccccccccccccccccccccccccccccccccccccccccccccccccccc ccccccccccccccccccccccccccccccccccc bbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbu uuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuum
m
m mmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmm m i
g i dijsd sjdnsjd ndjajsdnnsa adjdnawddddddddddddd uw
Flow Through Pipe: the analysis of fluid flow within pipesIndrajeet sahu
Flow Through Pipe: This topic covers the analysis of fluid flow within pipes, focusing on laminar and turbulent flow regimes, continuity equation, Bernoulli's equation, Darcy-Weisbach equation, head loss due to friction, and minor losses from fittings and bends. Understanding these principles is crucial for efficient pipe system design and analysis.
Blood finder application project report (1).pdfKamal Acharya
Blood Finder is an emergency time app where a user can search for the blood banks as
well as the registered blood donors around Mumbai. This application also provide an
opportunity for the user of this application to become a registered donor for this user have
to enroll for the donor request from the application itself. If the admin wish to make user
a registered donor, with some of the formalities with the organization it can be done.
Specialization of this application is that the user will not have to register on sign-in for
searching the blood banks and blood donors it can be just done by installing the
application to the mobile.
The purpose of making this application is to save the user’s time for searching blood of
needed blood group during the time of the emergency.
This is an android application developed in Java and XML with the connectivity of
SQLite database. This application will provide most of basic functionality required for an
emergency time application. All the details of Blood banks and Blood donors are stored
in the database i.e. SQLite.
This application allowed the user to get all the information regarding blood banks and
blood donors such as Name, Number, Address, Blood Group, rather than searching it on
the different websites and wasting the precious time. This application is effective and
user friendly.
Build the Next Generation of Apps with the Einstein 1 Platform.
Rejoignez Philippe Ozil pour une session de workshops qui vous guidera à travers les détails de la plateforme Einstein 1, l'importance des données pour la création d'applications d'intelligence artificielle et les différents outils et technologies que Salesforce propose pour vous apporter tous les bénéfices de l'IA.
1. Get Homework/Assignment Done
Homeworkping.com
Homework Help
https://www.homeworkping.com/
Research Paper help
https://www.homeworkping.com/
Online Tutoring
https://www.homeworkping.com/
click here for freelancing tutoring sites
KATHMANDU MEDICAL COLLEGE
Sinamangal, Kathmandu
Case Study of Oligohydramnious
2. Submitted To : Submitted By :
Department of Postnatal Shikshya Dhakal
Mrs. Gayatri Rajbhandari Bsc. Nursing 2nd
year
Nursing Co-ordinator 7th
Batch
Acknowledgement
This case study report is prepared during my midwifery major nursing clinical
practicum in "Kathmandu Medical College Hospital". The report is prepared as a
requirement of Bachelor in nursing curriculum when I was posted in postnatal
ward.
I had an opportunity to gain experience and knowledge in this field. I got
myself completely involved in the care and management of the patient during the
period. However the work wouldn't have been accomplished successfully with my
effort only.
So, I would like to express and give a great thank to my teachers who are in
the clinical area. I am thankful to all the staffs in hospital for kind co-operation. I
am also thankful to my patient and her family for providing me valuable
information and trusting me. I am also thankful to my colleagues who co- operated
with me in preparing this case study.
2
3. Shikshya Dhakal
Bsc Nursing 2nd
year
7th
batch
Roll no: 8
Table of contents
Preface
• Background
• Selection of case
• Objectives
Part I
Introduction of patient
1. Biographical Data of the patient
2. Obstetrical health history of patient
3. Physical Examination
Part II
1. Introduction of oligohydramnious
2. Causes
3. Clinical features
4. Diagnosis
3
4. 5. Investigation
6. Complication
7. Management
8. Treatment
9. Introduction of Cesarean Section
Part III
1. Nursing care plan
2. Stress management
3. Discharge Teaching
Postface
• Summarization
• What I learnt from this case study
• References
Background
According to our curriculum we have to do one case study in midwifery
practicum, This case study report is prepared as a partial requirement of Bachelors in
nursing curriculum of Kathmandu university.
During 4 weeks of clinical practice of midwifery in Postnatal Ward of Kathmandu
Medical college hospital, we were required to do one case study on high risk case.
So I have chose the case of Oligohydramnious ". because it is one of the common
complicated pregnancy case.
Selection of the case study
1. I am interested to gain knowledge about disease Oligohydramnious, and its
management.
4
5. 2. It is one of high risk case.
3. I chose this case in order to give holistic care to the patient and give health
education for promotion and maintenance of life as well as provide psychological and
emotional support.
Objectives of case study
The general objectives of case study are to gain comprehensive knowledge about disease
as well as practical experience.
The specific objectives are
- To identify major risk factor of mother.
- To provide holistic nursing care and management to the patient.
- To teach mother and family to maintain and promote health of both mother and
baby so that it can minimize MMR, NMR and IMR.
- To gain comprehensive knowledge by comparison book with real patient.
- To collaborate with client families and other health team member in management of
patient.
- To gain through knowledge about oligohydramnious and its management and
treatment.
-To demonstrate skills which is needed for mother during hospitalization period.
5
6. -To collaborate with patient and other health team members for planning discharge and
follow-up visit.
Introduction of patient
Sita Rai of 26 yrs old, wife of Ramesh Rai, the resident of Balkumari was admitted in
Postnatal Ward on 2070/02/22. She came at hospital with the history of Pain abdomen.
Biographical Data of the patient
Name: Sita Rai
Age/sex: 26 yrs / F
Marital status: Married for 2 years
Husband Name: Ramesh Rai
Religion: Hindu
Education: Literate (+2 Pass)
Occupation: Housewife
Address: Balkumari-8,Lalitpur
Gravida/para: Primi
Date and time of admission: 070/02/22 at 8:00am
Inpatient no: 12753
Bed no: 314
Diagnosis: Emlscs for oligohydramnious
Ward: Postnatal ward
Date of delivery:2070-2-27 at 6pm.
Date of discharge:2070-3-1 at 12md
Menstrual history
Menarche - 14 yrs
Menstrual cycle - 27-29 days regular
Blood flow - 3-4 days normal
Dysmenorrhoea - not present
Medical/ surgical history
-No history of PTB, NTN, DM or any other medical disorder
-No hospitalization history.
-She had not other genetic or hereditary diseases.
-She had not done any operation.
Obstetrical history
1.)Past obstetrical history
Primi
2.)Present obstetrical history
LMP: 2069/05/21
EDD: 2070/02/28
Week of gestation: 39 weeks + 4 day
ANC visit: 4 visits in KMC
6
7. Immunization: 2 dose of Tetanus
Problem during pregnancy: morning sickness
Drugs: she had taken Folic Acid,Iron and calcium.
History of family
She has 7 family members. Her husband and others family members had no any health
problem. No history of PTB, HTN, DM or any other medical problem with her family.
She has a single family with medium socio- economic condition.
7
Family Tree
Mother SideFather Side
8. Physical Examination
Physical Examination
Physical examination is an important tool in assessing the patient’s health status.About
15% of information used in assessment comes from physical examination. It is
performed to collect objective data and co-relate it with subjective data. It also reveals
additional problems which the patient has not recognized.
Method of physical examination
The commonly used method of physical examination are:
-Inspection
-Palpation
-Percussion
-Auscultation
-Measurement
1.) General appearance :Fair
State of health: Healthy
Blood pressure: 110/80 mm of Hg
Pulse :78/ min
Temperature: 98F
Height:5.2 ft
Weight:52kg
2. )Skin
8
9. -Uniform colour and warm
-No dehydration
-No lesion ,No wound
-No rashes
3. )Head and Face
-Colour and texture of hair: Normal
-Hair distribution: Equal
-Head uniform size and shape
-No any injury in head and face.
4.) Eye
Normal in size and shape
-Colour of sclera: Normal
-Pupil react to light
-Vision:normal
5. ) Ears
-The top of the pinna met the middle canthus of the eye.
-No ear discharge
-Hearing: good
-Slightly wax present.
6. )Nose
-No any nasal discharge
-size and shape equal
-No polyps ,no blockage
7.)Mouth, throat and neck
-colour of lip pink, moist, no crack
-Teeth: no dental carries
-No gum bleeding
-Tongue moist and pink
-Thyroid not palpable
-Cervical lymph node not palpable.
8.) Breast
-Both breasts and nipples are symmetrical, uniform in shape.
-No tenderness or dipling present.
-No crack in nipples.
-Auxiliary lymph nodes are not palpable.
9.)Abdomen -
- No visible blood vessels.
- No any abdominal distension.
-Liver and spleen are not palpable.
-Linea Nigra and striae gravidarum present
10.)Arms and Legs (Extremities)
-Both hands and legs are symmetrical.
9
10. -Normal skin colour with sensation present.
-No oedema, cyanosis, clumbing nails.
-Capillary refill normal.
11.)Anus and Female genitalia
-No any discharge from genitalia.
-Anus pattern normal.
-No history of bleeding during defecation.
Systemic Examination
1. Chest and Lungs
-Symmetrical in shape
-Symmetrical in size of the breast, not engorged, no breast lump.
-Respiration normal and rhythm regular
-Chest clear no wheezing sound.
2. Cardiovascular
-No cynosis
-No heart murmur
-Normal lubdup sound
3. Gastrointestinal
-Abdominal shape of size: Flaccid types.
-No visible vein.
-No abdomen mass
-Bowel sound present
-Lever not palpable
-Spleen not palpable
4. Genitalia
-Slightly brown colour discharge
-Foul smelling
-Burning micturition
5. Musculo skeletal
-Easily mobility of hands and legs.
-Muscle strength good.
-No contracture, no deformity.
6. Nervous/ Mental
-Patient is fully conscious, co- operative, speech clear, no difficulty in speaking.
7.Sleeping Pattern
-Before, sleeping pattern was normal but now due to operation, it is slightly disturbed.
Delivery report:
10
11. Type of delivery-Emlscs
Date and time: 2070/02/27 at 6pm
Blood loss: 80ml
Baby Weight: 3.5 kilogram
Placenta weight: 400gm
Post delivery vital
T- 98.4 F
P - 78/min
R - 26/min
BP -Rt 120/80, Lt 120/70mm of Hg
Baby’s report
Sex: Male
Condition: Fair
APGAR score: 7/10, 8/10
Weight: 3500gm
Post delivery note of patient
Patient’s general condition was fair. I/V drip continuing and continued till evening then
omitted drip.
Patient’s general condition was fair. Patient was in normal diet. Oral medicine started.
Normal discharge of lochia was seen.
Post natal exam
Vitals:-
T – 98.2 F
P – 80/min
R – 22/min
BP – Rt 110/80, Lt 120/80
Headache – Not present
Epigastric pain – Not present
Blurred vision – Not present
Breast – Normal
Perineal area – No swelling
Her general condition was improving than the day before. I advised her to ambulate gave
her psychological support. She was planned to discharge next day.
Baby’s Physical Examination:-
Vital signs
Temperature – 98.8 F
Pulse – 138/min
Respiration – 38/min
Weight – 3500gm
Length – 50cm
Sex – Male
General condition – His movement of limbs, trunk, head and neck are normal.
11
12. Skin – No cyanosis, no jaundice, no rash, and colour is normal and lymph nodes are
normal.
Skull – Shape and size normal, no caput and haematoma, no any injury in head and both
fontanels are normal.
Eyes – Shape, size and position are normal, No discharge from eyes. No redness and
swelling of any part of eyes.
Ears – Normal, no discharge from both ears.
Nose – Normal, no discharge, swelling
Mouth – Lips are moist, no cracks, no swelling, no cleft palate and hair
Lips – colour of lips is pink. Shape and size of tongue is normal.
Neck – no congenital goiter, no any abnormal presentation.
Chest – Shape and size normal.
Abdomen – Cylindrical in shape and slightly distended. No cord bleeding, no rashes
present in skin.
Genitalia – Normal, No discharge
Limbs – Position of upper and lower limbs were normal. No any congenital deformity
found. No rashes, no extra fingers. Joint movement was also normal.
Spinal cord – Normal, no spina Bifida, no abnormalities
Anus – Normal, stool passed.
Rooting reflex – Present
Sucking reflex – Good
Swallowing reflex – Good
Gagging reflex – Not seen or observed.
Grasping, dancing, Tonic neck reflexes – Present
Babinski reflex- present
Developmental Task
Sita Rai is 26yrs old she belongs to young adulthood.
1.)Age group-21 to 39yrs.
2.)Young adulthood is the period of challenges rewards and crisis.
Challenge of entering the job, reward of a job well done and crisis associated with caring
of parents and rearing of children or family.
According to book According to patient
-The young adults achieve
independence from parental control.
-My patient was totally dependent to her
husband because she is housewife.
-They begin to delov strong friendship
and intimate relationship outside the
family.
-She has many friend outside the family.
12
13. -They establish personal set of values. -She has her personal identity and has
established self concept.
-They develop a sense of personal
identity.
-She had certain values of her life.
-They prepare a life work and develop
the capacity for intimacy.
-She got married and her husband is
very intimate.
-Establishing and managing a home and
time schedule and life stress.
-She also manage her home.
-Decide and carry out task of parenting. -She has two children she perfectly rear
them and she is interested to become
parent.
Disease profile
Oligohydrominous
Introduction
It is extremely rare condition where the liquor amnii deficient in amount of less than
500ml.It is often associated with the following condition.
i) With poor placental function and fetal growth retardation.
ii) Seen with obstructive lesion of the fetal urinary tract and with
renal agencies.
iii) In uniovular twins when one of the gestation sacs has excess of
liquor, the other sac may have very scanty liquor.
Etiology (according to book)
i) Amnion nodosum:-failure of amniotic fluid secretion.
ii) Obstruction of the urinary tract.
iii) IGUR associated with placental insufficiency
iv) Post maturity.
Etiology (according to patient)
Unknown
Diagnosis (according to patient)
i) The uterine size appears smaller than gestation period,
ii) There are other features of IUGUR.
iii) There may be fetal malpresentation (breech common).
iv) On abdominal palpation due to scanty liquor the fetal parts are prominent
and uterus feels full of fetus.
v) It the membranes are artificially ruptured for induction of labour or there is
spontaneous rupture of the membrane in labour, there is very scanty escape
of liquor which is very often meconium stained.
vi) Less fetal movement.
Diagonosis during delivery
13
14. i) Thick meconium stained.
ii) Scanty liquor.
iii) The fetal skin is markedly thick dry and lathergy and there evidence of
fetal deformity.
Diagonosis (according to patient)
i) Uterine size is much smaller than the period of amenorrhoea.
ii) The uterus is full of fetus because of scanty liquor.
iii) Less fetal movement present.
Investigation done in patient
Hb-12.3gm/dl
Blood Group-O+ve
VDRL-non-reactive
HIV-negative
HBSAG-negative
USG done
BPD Measures-90mm.
FL Measures-72mm.
AC Measures-312mm.
=37 WOG
Impression-Single Live Fetus With Cephalic Presentation.
-37 WOG
-Placenta Anterior Wall
-Liquor AFI 5cm
-EFW 3.2Kg
Effect of oligohydramnious
Early pregnancy
i) Amniotic adhesion or bands may cause deformities like amputation of
fetal limbs or constriction of the umblical cord.
ii) Pressure deformities such as club feet.
iii) Pulmonary hypoplasia has been reported.
iv) The skin becomes dry lethargy and wrinkled.
Late pregnancy
i) It is sign of fetal jeopardy as in case IUGR.
ii) Close adoption between the fetus and the uterine wall can lead to
pressure on umblical cord and obstruction to the flow of blood to and
from the fetus. Fetal asphyxia may result.
iii) Meconiun passed into a amniotic sac in which there is paucity of fluid
will not be diluted.
14
15. iv) Aspiration of this thick meconium by the fetus will lead to aspiration
pneumonia after birth.
Management (According to book)
There is no specific Rx for oligohydramnious. In some case termination of
pregnancy is carried out to forestall severe fetal hypoxia all fetal death in uterus.
Management (According to patient)
Normal delivery was conducted.
Treatment (According to book)
Prom is confirmed labor may be protracted and contraction is more painful.
Fetal distress occurs frequently because of frequent association of fetal malformation
vaginal delivery is favorable.
Treatment(According to patient)
Prom done
Complication
A. Maternal
i) Prolonged labor due to inertia.
ii) Increased operative interference due to malpresentation
iii) Lead to maternal mortality.
B. Fetal
i) Abortion
ii) Deformity due to intra-amniotic adhesion or due to compression
iii) Fetal distress in labor
iv) Cord compression
v) Fetal lung hypoplasia
vi) Skeletal deformities due to compression e.g. talipes
vii) Fetal mortality is high
Drugs used in my patient
-Tab cifran 500 mg BD
-Inj oxytocin 10 unit I/M
-Tab Aciloc 150mg BD
-Iron
-Calcium
Tab Cifran 500 mg BD
Ciprofloxacillin is a broad spectrum and bacterial drugs, which was introduced in
1987,which is 4-quinolone derivative derived from Nalidixic acid.It is highly effective
against Shigella,Salmonella,Neiseria,E-coli,Pseudomonas,H.influnza,Helicobacter
infection and methicillin resistant Staphylococci.
Mechanism of action
It inhibits the bacterial DNA synthesis by inhibiting DNA gyrase,which reverses the
super coiling of DNA stands,the enzymes that maintains the helical twists in DNA. Thus,
it kills the bacteria by inhibiting the DNA synthesis.
15
16. Indication
-Enteric fever
-Urinary tract infection
-Intra abdominal infection
-Gynaecological infection
-Bone and joint infection
-Gonorrhoea and septicemia caused by sensitive organism.
-Pelvic inflammatory disease
-Surgical prophylaxis in upper gastrointestinal procedures
Dose
• Adult
By mouth:
-General dose:250-500mg BD for days before meal.
-UTI:500mg BD for 7 days.
-Gonorrhoea:250-500mg in resistant case(single dose)with metronidazole and
Doxycycline.
-Contacts meningococcal meningitis:500mg single dose.
By I/m/IV
-UTI:IV minor infection 200mg BD moderate infection 400mg,severe infection 400mg
TDS.
-Gonorrhoea:100mg single dose.
-Enteric fever:400mg BD for 10days.
• Child
By mouth:
-General dose:10-20mg/kg 12 hrly before meal.
-Enteric fever:30mg/kg 12 hrly.
By I/V
Dose:4-8mg/kg 12 hourly.
Adverse effect
GIT: Nausea, vomiting, epigastric distress, flatulence.
CNS: Headache, dizziness, depression, insomnia.
Urinary: Crystal urea, renal failure ,nephritis.
Bone and joint: Damage to growing cartilage, arthralgia.
Skin: Skin rash including very severe exfoloative dermatitis.
Blood: Increase blood urea and creatinine, blood disorders.
Liver: Hepatitis(disturbances in liver enzymes and bilirubin.
Miscellaneous: Anaphylaxis, Stevens-Johns syndromes, lyell syndrome.
Contraindication
Hypersensitivity to fluroquinolones.
16
17. Nursing implication
-I/V ciprofloxacin should be administer infusion over a period of 60 min. Total daily
dose should be halved in severe renal impairment.
-While taking this medicine, tell them to drink a lot of water.
-Give this medicine in empty stomach food interfere its absorption.
-The dose of the medicines should be completed.
-The dose should not be skipped at all.
Tab calcium
Action- Maintain cardiac function nerves activities and muscle contraction, coagulation
of blood and for maintaining structural integrity of cell membranes. It plays an important
role during period of bone growth in childhood adolescent, during pregnancy and
lactation.
Dose: Tab 250 mg - 500mg OD
Indiations - Osteomylitis, pregnancy ,lactation
Side effects
-Anorexia
-Nausea, Vomiting
-Abdominal pain
-Dry mouth, thirsty
-Poly- urea
-Confusion
-Delirium and coma
Nursing Implication
-To increase fluids
-Not to use antacid unless directed by physician
-Laxatives or stool softeners constipation occurs.
Cap Iron
Action: Replaces iron store, needed for red blood cell development, energy and oxygen
transport. It works in iron deficiency anaemia, prophylaxis for Iron deficiency in
pregnancy.
Dose-40 mg OD
Indication - Pregnancy, Anaemia
Side effects -
-Nausea, vomiting
-Constipation
-Epigastric pain
-Black and red torry stools
-diarrhoea
17
18. -Temporarily discoloured tooth enamel and Eyes.
Nursing Implication
-Assess blood toxicity, nausea, vomiting, diarrhiea haemat, oemesis, pallor, cyanosis,
shock, coma, dimination.
Introduction of Cesarean Section
Cesarean Section
It is an operative procedure whereby the fetus after the end of 28th
weeks is delivered
through an incision on the abdominal and uterine wall. This excludes delivery through an
abdominal incision of a fetus lying free in the abdominal cavity following rupture of the
uterus.
Indication
Complications of labor and factors impeding vaginal delivery, such as:
• prolonged labour or a failure to progress (dystocia)
• fetal distress
• cord prolapse
• uterine rupture
• increased blood pressure (hypertension) in the mother or baby after amniotic
rupture
• increased heart rate (tachycardia) in the mother or baby after amniotic
rupture
• placental problems (placenta praevia, placental abruption or placenta
accreta)
• abnormal presentation (breech or transverse positions)
• failed labour induction
• failed instrumental delivery (by forceps or ventouse (Sometimes a trial of
forceps/ventouse delivery is attempted, and if unsuccessful, it will be switched
to a Caesarean section.)
• large baby weighing >4000g (macrosomia)
• umbilical cord abnormalities (vasa previa, multilobate including bilobate
and succenturiate-lobed placentas, velamentous insertion)
Other complications of pregnancy, pre-existing conditions and concomitant
disease, such as:
• pre-eclampsia
• hypertension[32]
• multiple births
• previous (high risk) fetus
• HIV infection of the mother
• Sexually transmitted infections, such as genital herpes (which can be passed
on to the baby if the baby is born vaginally, but can usually be treated in with
medication and do not require a Caesarean section)
• previous classical(longitudinal) Caesarean section
18
19. • previous uterine rupture
• prior problems with the healing of the perineum (from previous childbirth
or Crohn's disease)
• Bicornuate uterus
• Rare cases of posthumous birth after the death of the mother
Contraindications:
A patient who is pregnant or who wants to become pregnant in the
future. Pregnancies following ablation can be dangerous for both mother and fetus.
A patient with known or suspected endometrial carcinoma (uterine cancer) or pre-
malignant conditions of the endometrium, such as unresolved adenomatous
hyperplasia.
A patient with any anatomic condition (e.g., history of previous classical cesarean
section or transmural myomectomy) or pathologic condition (e.g., long-term
medical therapy) that could lead to weakening of the myometrium.
A patient with active genital or urinary tract infection at the time of the procedure
(e.g., cervicitis, vaginitis, endometritis, salpingitis, or cystitis).
A patient with a intrauterine device (IUD) currently in place.
A patient with a uterine cavity length less than 4 cm. The minimum length of the
electrode array is 4 cm. Treatment of a uterine cavity with a length less than 4 cm
will result in thermal injury to the endocervical canal.
A patient with a uterine cavity width less than 2.5 cm, as determined by the
WIDTH dial of the disposable device following device deployment.
A patient with active pelvic inflammatory disease.
Types of Cesarean Section
1. Elective Cesarean Section
2. Emergency Cesarean Section
Nursing Management
1.Psychological support to patient and family.
2.Encourage to ventilate her feelings.
3.Explain about the intra-uterine fetal death and possible complication.
4.Advice to take frequent small amount of food it stimulate appetite and digestive.
5.Advice to take nutritious and iron containing food and vegetables.
6.Advice about personal hygiene.
7.Control of visitors and noise near the pt's room.
8.Counselling for family planning upto 1-3 yrs spaces minimum.
After Delivery, I assisted my patient to get out of the bed, ambulation, exercise,
morning care, changing dresses etc.
19
20. I gave health teaching on different topics as necessary. eg. the importance of
ambulation, rest and exercise, diet, breast feeding, infection prevention and oral
hygiene etc.
20
21. NURSING CARE PLAN
S.N Nursing
Diagnosis
Nursing goal Nursing
implication
Rational Evaluation
1.
2.
Anxiety
related to
unfamiliarity
with hospital
environment
Pain related to
uterine
contraction(pr
ogress of
labour)and
descent of
foetus in the
pelvis.
-Pt will
express
reduced
anxiety after
interventions.
-patient will
have a relaxed
body posture
and facial
expression
after
intervention.
Patient will
have a relaxed
facial and
body
appearance
between
contractions.
-Greet patient and
their family
warmly on arrival.
-Briefly orient
patient about
birthing room,
explain any
equipment that is
increased including
its purpose.
-Talk with women
about what they
expect of the birth
experience for
example, ask who
they plan on having
present at birth and
of medications.
-Assess for
presence and
character of pain
continuously
during labour
such as type of
contraction,
frequency and
duration ,facial
expression ,crying
and moaning
during and between
contractions.
-Provide general
comfort measures
such as adjust the
room temperature.
- Encourage
women to assume
-Makes family feel
welcome and that staff
will be considerate of
their needs and desires.
-Teaching helps decrease
fear related to the
unknown and increases a
sense of personal control
over the situation.
-Enables nursing staff to
help women achieve their
expected experience
more closely, which
promotes their
satisfaction even if all
their expectations are not
met. They will probably
be less anxious of they
believe staff cares about
their desires.
- Assessment enables to
identify whether pain is
normal for Patients.
Labour status and it also
helps to identity the best
inter ventions for plain
relief.
- Evaluating non verbal
and verbal
communication helps to
evaluate need for pain
relief in pt.
- These general measures
reduce outside irritants.
- Position Changes
promote comfort and
help the fetus adept to
size & shape of pt's
-Patient did not
express fears.
-patient sits in
bed in
comfortable
position.
Pain is minimize
after maintained
pt. position and
psychological
support.
21
22. position she finds
most comfortable
other than the
supine.
- Observed for a
full bladder every
one to two hrs.
pelvis.
- Supine position can
result to reduced
placental blood flow and
fetal oxygenation.
22
23. S.No Nsg
diagnosis
Goal Implementation Rationale Evaluation
1. Anxiety
related to
knowledge
deficit
regarding
pain its
prognosis.
She gained
knowledge
about
pain
management
and its
relaxation
technique and
prognosis
1. Reassurance the
patient and visitors.
2. Provide positive
reinforcement
when
desired response is
achieved.
3. Keep in comfort
position helps
while
turning position.
4. Listen
attentively,
encourage
verbalization
provide a caring
touch.
5. Give pain killer
medicine
six hourly or
according to
Doctor order.
6. Teach about pain
and
its prognosis.
1. Maintain a good
interpersonal
relationship.
2. Positive feedback
helps self confidence.
3. These reassure the
patient that she is not
alone.
4. These techniques
allow an out for anxiety
and help to control pain.
5. To relieve operation
site pain.
6. Knowledge upgrade
and co-operation for her
condition.
She has
gained
knowledge
about pain
and
relaxation
technique .
Her pain
control.
23
24. S.No Nsg
Diagn
osis
Goal/Obj
ectives
Nsg
Intervention
Rationale Evaluation
3. High
risk
for
infecti
on
1. Patient
will
remain
free
from
Infection
during
hospitaliz
ation as
well as
at home.
1. Perineal
care done 12
hrly
2.Emphasized
or changing
sanitary pad.
3.Breast care
done daily and
teach
technique to
the patient.
4.Encourage
to take
nutritional
diet with
plenty of
fluids.
5.Advice hand
washing
before
Touching the
baby.
6. Advice for
nail cutting.
1. It helps to limit potential
source of Infection. It also
provides opportunity to see lochia
and its colour and order take
action accordingly.
2. It helps to limit potential
source of Infection. It also
provides opportunity to see lochia
and its colour and order take
action accordingly
3. It helps to promote circulation
to clean nipple for baby.
4. It helps to provide body
requirement for nutritional and
prompt health status.
5. To prevent cross infection.
6. To prevent from injury and
infections.
7. To observe baby skin.
8. To prevent from infection.
9. Decrease possibility of
introducing pathogens.
Mother and baby are
free from infection
that’s why objectives
were fulfilled.
S.NNrsg Diagnosis Goal Implementation Rationale Evaluatio
n
2. Potential to
develop
post delivery
complication.
-chest pain
-Deep vein
thrombosis
Prevent from post
delivery
complication
during
hospitalization.
-Teach deep
breathing
and coughing
exercise.
-Instructions
regarding the
importance of
deep.
-Encourage
exercise and
ambulation.
-Improve the pulmonary
ventilation, mobilizes
secretions and stimulate
circulation.
-Teaching regarding
pulmonary mechanics
from foundation of self
care.
-Ambulation maintains
muscle tone and prevents
muscle atrophy and
prevents thrombophlebitis.
She has
not
develops
any post
delivery
complicat
ions so
that my
goal was
met.
24
25. 7. Baby bath
done.
8. Eye care
and umbilical
care done.
9. Antibiotics
as ordered by
doctor
Stress Management
Stress is an unpleasant experience of the life. During hospitalization patient suffer
from stress because of new environment.
Stress is a change in the environment that is perceived as a threatening challenging and
damaging to the person’s equilibrium as dynamic balance .When stress is more severe or
more prolonged than usual, however a person may need a nurses help in coping with
stress.
My case study patient Sita Rai was suffering from stress due
to hospitalization and new environment and she was upsat of her baby.
To minimize her stress, I followed the following techniques which are as follows.
-I provide plenty of time to express her feeling.
-I gave psychological support.
-I built good rapport with patient and her family.
-Allowed her family member to visit her.
-Give proper information regarding each and every procedure.
-Relevant information has been given day to day about treatment and prognosis of her
condition.
*Divertional therapy has been applied for stress reduction which are as follows:
-Talk therapy
-Providing newspaper and other favourate objects.
-Audio/visual aids, for e.g. television.
-Imaginary technique.
-Imaginary visualization.
-Distraction.
-Progressive muscle Relaxation.
-Autogenic training.
25
26. Health Teaching/Discharge Teaching
Health Teaching plays an important role to prevent disease, promote health as well as to
cure disease more rapidly with out any complication .one of the most important roles of
the nurse is to provide health education. So, I being a nurse, I had also given health
education to patient and family.
• To promote the health.
• To motivate for early diagnosis and treatment.
• To help limit the disability
• To keep in relationship
Keeping above objectives in mind I had given health education to the patient about
following topics:-
Topics Advice/ Health Education
1.Nutrition Postnatal mother needs balance diet which should have adequate
protein,
carbohydrate, calcium, iron etc. Balance diet helps to regain her health
and
her baby’s health add to promote health and her baby’s health add to
promote
health and lactation. She must eat 4 times per day which is required for
lactation.
Baby needs good nutrition So mother has to breast feed the child
regularly till 4-5
month without water also. This is the only one source of good nutrition
for the baby.
She has to take care about this.
2.Rest and
Activities
Rest and sleep is very important. So she has to rest in a day also. Sleep
pattern should
be good. Light exercise can be done. Lifting heavy thing should be
26
27. avoided. Especially
post natal exercise such as abdominal breathing, arm raises exercises.
3.Personal hygiene This should be done to prevent infection. Inner clothes should be
cleaned, dry and changed
frequently. Pericare and breast care should be encouraged.
4.Sexual Intercourse
and family planning
We discussed about sexual intercourse and family planning method. I
taught her to prevent
some complication to the mother and I advice to use temporary family
planning
method which she used to like after 45 days because she was primipara
mother
5. Care of the baby Gently handling of baby care of eyes, ears and groins with warm cloth,
periodic bath and oil
massage, frequently change of napkin, check frequently urine and stool
pass.
6. Breast feeding to
baby
I advice to teach her about demand feeding, exclusive breast feeding.
Breast milk secretion
high in amount in night than in day so breast feed in night as well as
day. Exclusive breast feeding
help to temporary family planning method.
7.Immunisation of
baby
I explained about important of Immunisation and schedule of
Immunisation and its purpose.
8. Medicine Doctor has prescribed the following medicine. Tab Ferrous sulphate 1
tab OD for 1 month. Tab
Calcium 1 tab OD for 1 month. I explained about its usefulness.
9. Follow up Suggest for importance of routine check up and health for follow up
purpose.
10. Others
Immediate check up if any signs of infection, fever, severe headache,
pain swelling, foul discharge,
Convulsion etc. If baby has any problem such as dyspnoea fever, not
sucking breast milk, increase
Respiration etc. to visit the doctor as soon as possible.
Discharge teaching
I had given health teaching to the patient and her family on the following topics-
1.Having adequate rest and sleep.
2.Nutritional diet.
3.Personal hygiene.
4.Regular medication on time.
5.Follow -up visit.
6.Family planning method.
7.For being more conscious and to do regular antenatal visit in coming
pregnancy.
27
28. Summarization
According to our 4 weeks midwifery practical we had to do two case studies. I chose the
case of Oligohydramnious. I got opportunity to observe the cases and provide nursing
care according to need.
I selected the case of oligohydramnious. My patient name was Sita Rai 26 yrs old
admitted in Postnatal Ward with the diagnosis of Emlscs for oligohydramnious.
During the whole period of hospitalization I provided holistic nursing care to her
considering her mental, socio-cultural aspects of nursing care.
Her condition was improved and recovered. So discharged on as per plan. During
hospitalization I gave health education ,regarding nutrition, rest, breast, feeding, exercise,
regular health check up and follow up etc.
28
29. What I learnt from this case study ?
From this case study I learnt about oligohydramnious in depth. While doing
case study, I got many opportunities to gain scientific knowledge and theories in
patient and evaluate the outcomes and finally write result. I gained confidence in
caring and managing the case of oligohydramnious.
Case study helps to gain lot of theoretical as well as practical knowledge and it
helps to apply our theoretical knowledge in practical. It also improve writing
skills. I got chance to study patient and family background, socio-cultural,
environmental background of the patient.
29
30. References
1. D.C Dutta - Text book of obsetrics 5th edition
2.Nursing drug handbook -19953
3.Manual of midwitery A- Roshani Tuitui
30