Please help me w/ OB Careplan

[Aimee.K]

help with ob careplan!

i have recently been assigned to the l&d section of northeast georgia medical center for my clinicals at ngcsu. i worked with a client that had 3+ meconium staining, a baby with freq, long duration decelerations:o . the midwife initiated an amniotransfusion, internal monitoring and started pit. i was trying to work on a care plan for this patient but, nothing is in any of my care plan books in regards to these serious conditions. i thought i could make up my own diagnosis but my instructor said i can't. are there any care plan books available that do not ignore the pregnat patients? does anyone have any ideas?:rolleyes:d . care plans are no fun! please help!

aimee

2nd year adn student:rolleyes:

[Talino]

I'm no L&D expert but the "unpopular" care planning process is universal to all areas of nursing.

Your instructor is right. Unless you identify the actual problem and know it's pathophysiology, you can not just make up a care plan.

I can make out a care plan for you but your instructor may not appreciate it. I can however give you a clue.

First, identify the actual problem which is presence of meconium. What does prolonged exposure to meconium do to the baby? So, ...

Problem: "Potential for baby to develop ...(due to effects of prolonged exposure to meconium)"

Goal: Child will be delivered ...(experience less, be free of s/s, protected from the effects of actual problem, etc.) Note in this scenario, the unborn child is most at risk not the mother.

Mother would likely be anxious, worried, so goal for mom would be - "Mother will .... (feel comfortable, be less anxious,etc.)"

Nursing Interventions: (assuming Medical interventions are already carried out - meds, amnioinfusion, etc.)

Identify the possible adverse effects to the both mother and child on drugs used or procedures performed to correct the problem, e.g. effects of Amnioinfusion (not transfusion). What do you do as a nurse to prevent or alleviate the occurrence of adverse effects, what do you watch for while rxs are going on? What do you teach the mother to avert recurrence of problem, etc. And blah, blah, blah goes on.

Some helpful reading on meconium aspiration sydrome pathophysiology --->http://www.familypractice.com/journal/abfpjournal_frame.htm?main=/journal/1999/v12.n06/1206.04/art-1206.04.htm

Amnioinfusion Protocol by a reputable hospital Nursing Dept. (this URL requires an Acrobat reader) ---->http://www.med.unc.edu/nursing/manuals/protocol/amninf.pdf

___________________