Case Presentation Help

Published Oct 29, 2009

82 Posts

I have to present the following case study. I made a Powerpoint Presentation with all the answers. I just wanted to know if any experienced L&D nurses had any input to offer regarding this case study besides "do your own homework." Thank you in advance!

Scenario:

T.N. Delivered a healthy male infant 2 hours ago. She had a midline episiotomy. This is her sixth pregnancy. She is para 4014. (Para indicates past history and does not list this delivery until later.) She had an epidural block for her labor and delivery. She is now admitted to the postpartum unit.

1. What is important to note in the initial assessment?

I used the acronym BUBBLE-HE

2. You find a boggy fundus during your assessment. What corrective measures can be instituted?

Uterine atony: Fundal massage, monitor vitals, check for full bladder, IV oxytocin, encourage breastfeeding, and monitor output

3. The patient complains of pain and discomfort in her perineal area. How should you respond?

Ice packs, positioning, donut cushion, sitz bath, local/PO analgesia

4. What patient teaching is vital for the nurse to do after delivery?

Teaching regarding reportable signs, fundal massage, infection-prevention, perineal care, hygienic practices, safety, bonding, breast-care, breast-feeding, etc

5. T.N. tells you that she must go back to work in 6 weeks and isn't sure she can continue breast feeding. What options are available to her?

Suggest pumping, breast-feeding schedule, refer to breast-feeding coordinator

Case Study Progress

T.N. believes the AM and PM breast feeding schedule will work for her once she returns to work.

We will be graded on the following basis:

*** Presentation teams must email the instructor a brief bibliography or reference list on the topic one week before the presentation. ***

Present the case study and examine the role of critical thinking in the clinical decision making process.
Analyze the case study using the principles of Roy Adaptation Theory or Paterson & Zderad Humanistic Science Theory in guiding the patient care.
Incorporate source of standards and guidelines for the care of patient with such a diagnosis. Include those of professional and institutional organizations and accrediting bodies such as the Nursing Code of Ethics, ANA Standards of Practice, JACHO standards, agency policies and procedures. Also specify the relevant standards employed to the specific case study be presented.
Examine the case study questions with the class. Clarify, add to, and/or correct responses as appropriate.
Based on data collected, identify assumptions in the case study, add missing data as appropriate. Indicate evidence of biases, specific values, legal and ethical issues, and the importance of significant others participation in patient care.
Demonstrate effective use of audio visuals.

I am having trouble with points 2 and 3 and 5 in the grading criteria. I will highly appreciate any input with regard to those points.