Www.mydsn.net



Obstetrical (OB) Nursing OB Preparation PacketStudent Name: (fill in your name & cohort)This part of the OB Preparation Packet will require you to view the 3 OB Videos on (in NUR350) or in the Simulation Google classroom. You must view the videos and use your textbook, Maternity & Women’s Health Care by Lowdermilk, et al. (2020) to complete this OB Preparation Packet. If you have clinical starting week 1 of the quarter ( Oct 4-10, 2020), your OB Preparation Packet needs to be completed before attending clinical, including the Medication Log. The OB Preparation Packet will be available week 11, to view and download at (NUR350), Google Classroom, then on Canvas the first day of the quarter. In addition, after completing the Medication Log, many clinical instructors want your completed medication list to be on individual 3x5 cards, preferably with a ring placed through the cards to make it easier to flip through the medications at the clinical site. All students need to complete the OB Preparation Packet and the Medication Log prior to your Simulation and Clinical experiences. When the Packet is completed, rename both documents with your name, date and cohort. Save as a .doc or .docx. Then, email your two documents to the OB professor indicated in the email from Dr. Kwiecinski by the end of the first week of your OB didactic class; by Friday- October 9, 2020. If your clinical starts the first week, let the OB professor know in your email subject line so it will be corrected first.Failure to email the completed OB Preparation Packet and the Medication Log by the due date, will lead to a failure for clinical. A student must achieve at least 78% on the OB Clinical Preparation Packet Rubric. Less than 78% will result in clinical failure. Note: Students do not need to upload the “How To Read Fetal Monitoring”; it is for your personal reference at your clinical site. All students must take the completed OB Preparation Packet to their individual clinical site. Grading Rubric:Competency23-25 points12-15 points7-10 pointsPoints EarnedLabor and DeliveryCompletely answers all questions to show understanding of concepts with fewer than 3 mistakesAnswers all questions with 3 or more mistakesDoes not answer all questions, or shows minimal understanding of materialPostpartumCompletely answers all questions to show understanding of concepts with fewer than 3 mistakesAnswers all questions with 3 or more mistakesDoes not answer all questions, or shows minimal understanding of materialNewbornCompletely answers all questions to show understanding of concepts with fewer than 3 mistakesAnswers all questions with 3 or more mistakesDoes not answer all questions, or shows minimal understanding of materialMedication LogMedication log is complete with action/use, dosage/route of administration, side effects/contraindications/precautions,nursing considerations and patient education for all medications with fewer than 3 mistakes Answers all questions with 3 or more mistakesNot all medications on log are completed, or with more than 3 missing areasTotal: OB Student Name: _________________________________________________Check list for the Clinical Instructor:First day of clinical, student has their finished OB Preparation Packet for L&D, Postpartum, the Newborn and the completed Medication Log.YesComments Student is present at clinical before the shift begins and stays through the required end time. After 7 minutes late, the student may not attend clinical and is sent home.Student’s adherence to Denver College of Nursing dress code at the clinical site- including DCN name badge. Student maintains academic integrity and adheres to the DCN Student Standards of Conduct.Students maintain HIPAA -includes PHI for electronic, written or oral information about the patient.Student has calculations checked by the faculty member prior to administering any medications.Student seeks help from faculty member as needed. Does not perform new skills/additional skills without consent or supervision of the faculty member.It is the student’s responsibility to notify the clinical office and the Instructor if they will be absent.Clinical Instructor will be present when the student performs the Newborn Assessment.OB Preparation: Labor and DeliveryUse your textbook Maternity and Women’s Health Care by Lowdermilk, et al., (2020), chapters 18 & 19 and the three videos viewed from to answer the questions based on the following scenario below.Camila Moreno just arrived in Labor and Delivery triage at 14:30. She is a 27 y/o Hispanic female, gravida 2, para 1 (G2 P1 or G2 P1001) currently at 39 wks gestation. Her first baby (now 2) was delivered via vaginal delivery after an induced labor of 16 hrs. She has received routine prenatal care, is GBS negative, blood type A positive, and is rubella immune. She plans to breastfeed. Camila stated that she has “been having contractions every 5-8 minutes for the last 2 hours and they are getting stronger.” She also stated that she had been having "a lot of false labor" in the last few days and feels anxious and hopes that this time it is “the real thing.” She reports active fetal movement and has some pink tinged vaginal discharge but denies any leakage of fluid. When asked to rate her pain, she replies that her current pain level is 7 on a scale of 0 to 10. Camila’s V/S are: temperature 37.1° C, pulse 80, respirations 18, and blood pressure 120/76. After 20 minutes on the monitor, the baseline fetal heart rate (FHR) is 130 bpm with moderate variability, and accelerations noted. Her contractions are now 3-5 min apart, lasting 60 sec & palpate moderate intensity. The nurse performs a sterile vaginal exam (SVE) and notes the patient’s cervix is 4 cm dilated, 80% effaced, soft and anterior with baby's head at +1 station (4/80/+1), with intact membranes. Her DTR’s are 2+, with 1+ edema in her lower extremities and no clonus. She gave a urine specimen in triage, results pending, and states she had a BM this morning. She last ate at 0800- a breakfast of eggs, toast and juice. The nurse reports their findings to the Provider and receives an order to admit the patient to L&D. Based on the FHR (fetal heart rate) parameters given in the scenario of baseline, variability and presence or absence of accelerations and/or decelerations, is this fetus well-oxygenated? Why or why not? Be specific. (Video & pp 363-366)What is the normal fetal heart rate (FHR) range? (Video) The BUBBLE LE is a DCN acronym for the labor and postpartum “Focused Assessment.” What would be Camila’s specific BUBBLE LE assessment? (Video) B UBBLELEUsing “VEAL CHOP,” describe what these decelerations below look like and what is likely causing them. What specific interventions(s) are needed? (Video & pp 367-368)Early deceleration-Late deceleration-Variable deceleration-What 5 measures should the nurse implement to provide intrauterine resuscitation for the fetus? (Video & pp 369-372)1.2.3.4.5.Post Delivery: the Apgar ScoresThe Provider arrives and at 1705 Camila gave birth to a baby boy in occiput anterior (OA) position. The baby was placed skin-to-skin on Mom’s chest and dried off. The clamping of the cord was delayed by 3 minutes. At 1725 the placenta was delivered. Camila is now bonding with her baby boy. What are the baby’s Apgar scores based on the following?Please rate the Apgar score by assigning the number following the heart rate, respiratory effort, muscle tone, reflex, and color on a 0-2 scale as described below then total the numbers:At one minute of age, the baby has:Heart rate: 120 Respiratory: cryingMuscle tone: active motionReflex: sneeze Color: blue, pale 1 minute Apgar score _____At five minutes of age, the baby has:Heart rate: 130 Respiratory: effort goodMuscle tone: active motionReflex: coughingColor: body pink, extremities blue 5 minute Apgar score _____ OB Preparation: PostpartumUse your textbook, Maternity & Women’s Health Care by Lowdermilk, et al., (pp. 425- 429, & pp 722-724, fig.33.1) and the three OB videos you watched to answer questions pertaining to postpartum nursing care.Case Study:You have just received Abigail Rice and her newborn to the postpartum unit. Abigail is 32-year-old biracial female, Gravida 1 now Para 1, who delivered a baby girl, Colby, three hours ago, at 38 2/7 weeks gestation. The newborn weighs 3260 grams (7 lbs. 3 oz.), length was 49.5 cm (19.4 inches) and is appropriate for gestational age (AGA). Abigail is GBS negative, blood type AB positive. She was vaccinated with Tdap during her pregnancy and is rubella non-immune. Your first assessment Vital Signs of mom are: temperature 37.5° C, pulse 88, respirations 20, and blood pressure 108/68. The fundus is “boggy”, 2 fingers above the umbilicus, slightly elevated and to the right of midline. A moderate to heavy amount of lochia and clots are noted. A 2nd degree midline vaginal laceration was repaired, is intact, perineal edema is present and two small hemorrhoids are noted.What is a boggy uterus? (pp 425, 722)What interventions are needed to firm up the uterus, decrease the bleeding and help stop the vaginal clots? Please list your interventions by priority. (pp 425-431)What would be the intervention for a uterus deviated to the right of the umbilicus? What if she was unable to void? OB Preparation: NewbornUse your textbook, Maternity & Women’s Health Care by Lowdermilk, et al., (chapter 24, pp. 486-530; 461 & pp. 734-758, 767) and the three OB videos you watched to answer questions pertaining to newborn assessment and nursing care.Before doing a NEWBORN ASSESSMENT, you need to know and look up the following:What is the newborn average length and range in inches & cm?What is the newborn average weight and range in grams & lbs.? (Note: 1 kg = 2.2 lbs. 1 lb. = 453.59 grams)What is the average and range of a newborn’s head circumferences in inches & cm?Define the acronyms below. What are the immediate risks for each of these fetuses and/or newborns? Be specific. (pp. 754-758, 767)AGASGALGA What is the normal newborn temperature range in both C° & F°? What is the newborn apical pulse range (sleeping and active)? What is the range of respirations in newborns (sleeping and active)? How long should you count respirations for? ( Video & p. 493) What is the range of normal newborn blood glucose levels in mg/dL? ( p. 511, table 24.4) What is the most critical physiologic change required of the newborn after birth? (Video & p. 461) The Infant’s head has overriding sutures with some molding, why does this adaptation occur? When will the infant’s head return to its normal shape? What assessments should be done to properly assess a newborn’s anterior and posterior fontanels? What are normal findings? What are abnormal findings? (p. 496) Hypoglycemia poses potential complications for the newborn: (pp. 468, 755 & 757).What signs and symptoms does the infant display when hypoglycemic? What specific sign of hypoglycemia can be quantified and reported to the provider? What is the treatment for the hypoglycemic infant? Thermoregulation of the infant is critical to the newborn’s survival. Please identify and define the 4 Heat Loss Mechanisms for the newborn and the interventions needed for each. (pp. 464-466, & pp. 734-735) 1.2.3.4. ................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download