Your patient is a 27-year-old nulliparous woman in her first trimester of pregnancy. She has had type 1 diabetes since she was 16 years old. Recently, she has been experiencing some nausea and is eating less as a result. She took her usual dose of regular and NPH insulin before eating a very light breakfast of tea and a piece of toast. Just before her midmorning snack at work, she began to experience nervousness and weakness. She felt dizzy and became diaphoretic and pale. Provide a rationale and reference for each response.
a. Identify the problem that this patient is currently experiencing and indicate why she is having these symptoms.
b. What action should this patient take and why?
2. S. O.’s pregnancy has just been confirmed and she also has type 1 diabetes. Provide a rationale and reference for a response.
a. As a result of her high-risk status, a variety of additional assessment measures are emphasized during her prenatal period to evaluate the status of her fetus. Identify these additional assessment measures and their relevance in diabetic pregnancy.
b. Discuss the stressors that might she and her family may face as a result of her status as a diabetic woman who is pregnant.
c. Write two nursing diagnoses with an associated intervention and goal that reflects her current health status.
d. Describe the focus, nursing interventions, and health teaching for diet, glucose monitoring and insulin requirements during antepartum.
e. Describe the focus, nursing interventions, and health teaching for diet, glucose monitoring and insulin requirements during intrapartum.
f. Describe the focus, nursing interventions, and health teaching for diet, glucose monitoring and insulin requirements during postpartum
1. Your patient has been in labor for 5 hours. Her blood pressure had been stable, averaging 130/80 when assessed between contractions and the FHR pattern consistently exhibited criteria of a reassuring pattern. A lumbar epidural block was initiated. Shortly afterward during an assessment of maternal vital signs and FHR, your patient’s blood pressure decreased to 102/60 and the FHR pattern began to exhibit a decrease in rate and variability. Provide a rationale and reference for each response.
a. State what your patient is experiencing. Support your answer and explain the physiologic basis for what is happening.
b. Write a nursing diagnosis and related intervention that reflects what is currently taking place with this patient.
c. What are your immediate nursing actions and why?
2. Your other patient is a primigravida, who has elected for a continuous epidural block as her pharmacologic method of choice during childbirth. Provide a rationale and reference for each response.
a. Identify the assessment that should be used to determine her readiness for the initiation of the epidural block.
b. Describe the preparation methods that should be implemented and why?
c. Describe two positions you could help her assume for the induction of the epidural block and why?
d. Outline the nursing care management interventions recommended while this patient is receiving the anesthesia to ensure her well-being and that of her fetus.
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