Ncp DR Complications
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Aliza Grace F. Savarez NCP in Polyhydramnios Name: L,M Room and Bed Numer: !!"#$ AP: %r. &uazon G' P! A( &! P( A( L) Chie* Com+lain : LaorPains %ia-nosis: +olyhydramious %a e ime Cues Need Nursin- %ia-nosis Goal o* care Nursin- /n erven ion 0valua ion %ec. $(, )($' 1:(( am 23ec ive: • Pre-nan 4omen o* A2G: !5 4ee6s and 7 days • G' P! A( • %ia-nosis: +olyhydramnios • 8l rasound resul o* cle* +ala e *e us. • Chan-es in *e al hear one 4i h Fe al radycardia 4i h decelera ion durin- con rac ion Ac ivi y# 09ercise Pa ern /m+aired -as e9chan-e *e a l ; rela ed o in erru+ ion o* lood *lo4 *rom +lacen a and *e us as mani*es ed y *e al con-eni al anormali y cle* li+ and +ala e ; Nurse<s Poc6e Guide, )($(; A* er series o* nursin- in erven ion =i hin !( o $ hour o* nursin- care, he +a ien 4ill: /n en ed ou come: &o have a e er ou come o* he +ressure *rom he +resen in- +ar y removin- or allevia in- he +ressure o im+rove *e al +er*usion. $. Moni or ma ernal vi al si-ns ). Moni or *e al hear ra e *re>uen ly, By o ainin- elec rical *e al moni orin- racin-. R: o o ain he resul i* i is anormal or no and o re+or he chan-es immedia ely. !. Chan-e ma ernal +osi ion usually he es +osi ion is 6nee#ches +osi ion. A %ec. $(, )($' $$:(( am ? Goal me @< A* er series o* nursin- in erven ion =i hin !( o $ hour o* nursin- care,in our " hours o* du y he +a ien 4as ale o: a. 2 ains a *e al hear one o* : $$: (( am 35 |P a g e
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Transcript of Ncp DR Complications
Aliza Grace F. SavarezNCP in PolyhydramniosName: L,MRoom and Bed Number: 338-1AP: Dr. TuazonG4 P3 A0 T3 P0 A0 L2Chief Complaint: Labor Pains Diagnosis: polyhydramious
Date / timeCuesNeedNursing DiagnosisGoal of careNursing InterventionEvaluation
Dec. 10, 20149:00 amObjective: Pregnant women of AOG: 37 weeks and 6 days G4 P3 A0
Diagnosis: polyhydramnios
Ultrasound result of cleft palate fetus.
Changes in fetal heart tone with Fetal bradycardia with deceleration during contraction
8:31 am = 118 bpm9:30 am = 140 bpm 10:30 am = 120 bpm
Normal range (120 160 bpm )
Excessive amount of amniotic fluid in the uterus
AFI of 24.9 cm
(Normal range from 500 to 1,000ml and 2,000 ml in polyhydramnios at 40 weeks gestation. And an AFI of 24-25 cm )
Activity-Exercise Pattern
Impaired gas exchange( fetal ) related to interruption of blood flow from placenta and fetus as manifested by fetal congenital abnormality (cleft lip and palate )
( Nurses Pocket Guide, 2010)After series of nursing intervention Within 30 to 1 hour of nursing care, the patient will: Intented outcome:To have a better outcome of the pressure from the presenting part by removing or alleviating the pressure to improve fetal perfusion.
a. The fetal heart rate will be in a consistent normal range with no decelerationsb. Maintain the safety of both mother and the child.
1. Monitor maternal vital signs2. Monitor fetal heart rate frequently, By obtaining electrical fetal monitoring tracing.R: to obtain the result if it is abnormal or not and to report the changes immediately.
3. Change maternal position usually the best position is knee-chest position. A Trendelenburg position or sims lateral positonR: to relieve the pressure of the presenting part so that the oxygen can get through the baby.4. Inform the client to report immediately if she feels the cord within the vaginaR: to give action immediately and to prevent any danger risks.
Dec. 10, 2014 11:00 am
Goal met
After series of nursing intervention Within 30 to 1 hour of nursing care,in our 8 hours of duty the patient was able to:
a. Obtains a fetal heart tone of :
11: 00 am
138 to 148 bpm
(Normal range 120 160 bpm )Consistently.
b. And the safety of the mother and the child is maintained. ( there are no signs of prolapse of the cord )
Aliza Grace F.Savarez St.N
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