GC COURSEWORK (Maternal April 13, 2020) - VARGAS
GC COURSEWORK (Maternal April 13, 2020) - VARGAS
GC COURSEWORK (Maternal April 13, 2020) - VARGAS
RR22
A. Moja Hamma is a 29-year-old woman pregnant with her first baby. Her
amniotic fluid. Moja called her nurse-midwife, who instructed her to come to the
hospital immediately. Moja drove herself and arrived in 20 minutes. Fetal heart
rate (FHR) was 100 beats/min. An obstetrician was consulted, and she scheduled
Moja for an immediate cesarean birth. Moja reacted calmly to the news that she
needed surgery until she realized her boyfriend would not be able to get to the
hospital in time to be with her in surgery. At that point, she refused to sign
permission for surgery, saying, “I can’t. I just can’t go through this alone.”
procedure for the birth of her baby? What would be your best action to help her
As a nurse, I will conduct a health teaching to the patient and explain to her
the possible risk factors if she will wait for her boyfriend to get a cesarean birth
during labor, birth and the immediate postpartum period. But then I will just tell
her to undergo the procedure without her boyfriend because there are many
2. After learning that Moja wanted to wait for her cesarean birth to begin until her
boyfriend arrives, the nurse learns the boyfriend has texted to say he cannot
possibly stay with Moja in the operating room; he’ll feel so nauseated he’ll
As a nurse, I will tell Moja that her boyfriend cannot accompany her so what
nurse and the midwife are stronger in providing the supportive care to the patient
3. Moja, who will have epidural anesthesia for her cesarean birth, refuses to
remove her contact lenses for surgery even though it is hospital policy for anyone
receiving anesthesia to do so. She tells the nurse, “I won’t be able to see my baby
afterward without them.” Would the nurse insist she take them out or ask the
I will ask the team if she will allow her but in general, you are not permitted
to wear contact lenses or glasses during surgery of any kind. If you wear clear
ones, they would not know that you were wearing one but it would be best to
leave them out it is because even during a cesarean section there is always a
possibility that the pregnant woman will be put under general anesthesia and
there is a risk of something going wrong and you needing to be sedated quickly
and once you are sedated they generally put an ointment directly on your eye,
and then close your eyes. It keeps your eye from drying out. Leaving your
4. Moja Hamma refuses to allow the nurse to assess her fundal height after her
cesarean birth because she has so much pain. How would the nurse approach this
situation?
5. The nurse is interested in exploring one of the 2020 National Health Goals
research is allotted based on these goals. What would be a possible research topic
to explore, pertinent to these goals, that would be applicable to Moja and her
fourth child as naturally as possible, the same as she did for her other three
children. Her husband, Paul, the chief executive of a public relations firm, is with
her in a birthing room as her support person. He assures you Amy is a “veteran”
at labor, will use controlled breathing as pain management, and will have no
problems. He adds they are especially looking forward to this baby because she
will be their first girl. Four hours into labor, Amy experiences sharp abdominal
pain and begins to have fresh vaginal bleeding. Amy’s blood pressure falls to
placental abruption and asks you to prepare her for an emergent cesarean birth.
1. Because having a cesarean birth is so opposite from what the couple planned
for labor, Paul says he wants to investigate Amy’s symptoms on the Internet using
his laptop or else secure a second opinion from another doctor before surgery can
I will educate the husband of the mother that placental abruption is one of
2. Amy realizes immediately that something is wrong. She asks you if this has
something to do with the fact she is having her first girl. Are more girl infants born
male fetuses is related to the larger size of the male fetus, whereas the increase
for fetal distress is not, and may relate to other developmental differences
between male and female fetuses. But it does not necessarily mean that they are
their first baby girl that us why there is something wrong with her labor.
3. Amy is transported to surgery and, within 20 minutes, a 7-lb 3-oz girl is born.
afterward to the neonatal intensive care nursery for care. Paul declines to visit
Honor in the nursery. He says he’ll wait until Amy can be “disappointed” along
with him. What actions could you take to help this couple begin bonding with their
new daughter?
Bonding is the intense attachment that develops between parents and their
baby after giving them birth and bonding is very essential for babies. Most infants
are ready to bond immediately. Parents, on the other hand, may have a mixture
of feelings about it. Some parents feel an intense attachment within the first
minutes or days after their baby's birth. For others, it may take a bit longer.