NU 661 Week 8 Discussion 1 Advocating for Patient Care
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NU 661 Week 8 Discussion 1 Advocating for Patient Care
Paper Instructions
Initial Post
Create and post a 3–5-minute video response to this physician and advocate for a different plan of care for your patient. Prepare your video as if you were actually speaking to the physician, including using professional language and professional attire.
In your video be sure to include your specific plan of care (testing, medications, and so on). If you agree with the physician regarding bedrest, give supporting evidence. If not, then support your plan.
In your post, in addition to the video, attach a Word document that outlines your plan of care for that patient and includes a list of APA-formatted references to support your plan of care for your patient. Post your video and reference list no later than Day 3.
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Sample Answer
Preterm labor as described in the video occurs when the mother’s body starts the fetus delivery process before the 37th week of gestation. Normal labor is supposed to occur two weeks before or after the expected delivery date, between 38 weeks to 42 weeks.
When the mother starts labor between the 20th and 37th week of gestation, it is considered preterm labor. It is highly associated with premature births and increased morbidity to breathing problems and learning difficulties among other physical complications to the premature baby(Garfield& Chin, 2020).
As a new practicing nurse practitioner, it is necessary to conduct a comprehensive assessment of the mother’s pregnancy and develop the most effective care plan to prevent the complications associated with preterm labor.
The assessment process entails complete patient history focusing on signs and symptoms suggesting preterm labor such as backaches, cramping, light to heavy vaginal bleeding, rupture or tear of the amniotic sac, and contractions which occur at intervals of less than 10 minutes, in addition to flu-like symptoms such as diarrhea, and nausea and vomiting (Griggs et al., 2020).
Consequently, the patient history taking should also focus on possible risk factors such as the shortened cervix, multiple pregnancies, history of premature births, polyhydramnios, fetal birth defects, use of illicit drugs, age of the mother, and infections among others. Despite the diagnosis being made based on the patient presenting signs and symptoms, certain lab procedures must be ordered to confirm the primary diagnosis.
Such assessments include pelvic examination, ultrasound, uterine monitoring, and lab tests such as vaginal swabs and urinalysis to confirm the presence of infection. the test results for patients with preterm labor will display immature pulmonary development of the fetus and cervical dilation of less than 4cm, in addition to the absence of factors that contraindicate continuity of the pregnancy (Taghinejad et al., 2021).
The patient treatment plan will mainly involve suppression of the preterm labor. The nurse must thus monitor closely for signs of increased risk of fetal injury and signs of maternal anxiety. Clinical guidelines recommend the surgical procedure and medication such as corticosteroid, magnesium sulfate, and tocolytics as treatment options providing a temporary solution (Patel & Ludmir, 2019).
Corticosteroids help with fetal lung development, magnesium sulfate helps reduce the risks of cerebral palsy whereas tocolytics help in slowing down contractions. However, the nursing care plan to minimize the risks of fatal injury will involve assessment of the mother’s condition which can lead to steroid contraindication for maturation of fetal lungs, administration of the prescribed medication appropriately, and monitoring the heart rate of the fetus for cervical changes (Cetinkaya& Kusdemir, 2018).
It is also necessary to assess the anxiety level of the mother, and associated triggers by asking open-ended questions. It is also necessary to consider preventive measures for the management of preterm labor and inform the mother and her spouse of the need for follow-up care. The mother must be educated regarding the signs of hypoglycemia and sepsis and provided with emergency contact information in case they occur.
References
- Cetinkaya, S., & Kusdemir, S. (2018). A premature baby’s nursing care plan. Open Journal of Obstetrics and Gynecology, 8(05), 437. https //doi.org/10.4236/ojog.2018.85050
- Garfield, L., & Chin, E. (2020). Pharmacology for preterm labor. The Journal of Perinatal & Neonatal Nursing, 34(2), 155-161. https //doi.org/10.1097/JPN.0000000000000474
- Griggs, K. M., Hrelic, D. A., Williams, N., McEwen-Campbell, M., & Cypher, R. (2020). Preterm labor and birth a clinical review. MCN The American Journal of Maternal/Child Nursing, 45(6), 328-337. https //doi.org/10.1097/NMC.0000000000000656
- Patel, S. S., & Ludmir, J. (2019). Drugs for the treatment and prevention of preterm labor. Clinics in perinatology, 46(2), 159-172. https //doi.org/10.1016/j.clp.2019.02.001
- Taghinejad, F., Nikfarid, L., Monfared, M. N., Hoseini, N., & Habibi, S. (2021). Nursing diagnoses of preterm infants in the neonatal intensive care unit A cross-sectional study. Journal of Neonatal Nursing, 27(6), 451-458. https //doi.org/10.1016/j.jnn.2021.06.007
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