HELP me pls! asap! NCP!

Daytonite, BSN, RN · Jul 13, 2008

i very much doubt that any student is going to share a care plan that they might have done on a patient with you. why? the purpose of students doing care plans is to learn about the medical condition of the patient as well as the treatment and nursing interventions. you'll never learn them if you depend on someone else to do all the work for you. after doing just one care plan most nursing students understand this. it's very unlikely that there is a pre-printed care plan for these situations on the internet. are these the first care plans that you have been asked to write? so, what is it about these medical problems that you are having problems understanding? what is it about writing a care plan that you don't understand?

if you don't understand how to write a care plan

see https://allnurses.com/forums/f50/help-care-plans-286986.html - assistance - help with care plans
http://www-isu.indstate.edu/mary/carep2.htm - sample care plan for fluid volume excess

if you don't understand placental abruption

abrupt ruptured placenta refers to the premature separation of a normally implanted placenta from the uterine wall. this condition usually occurs after 20 weeks of pregnancy but may occur as late as during the first or second stage of labor. it's most common in multigravidas--usually in women age 35 and older--and is a common cause of bleeding during the second half of pregnancy.
the primary cause is unknown, but follows a specific pattern. blood vessels in the placental bed spontaneously rupture. as blood enters the muscle fibers, complete relaxation of the uterus becomes impossible. if bleeding continues, the placenta may be partially or completely sheared off.
symptoms of abruptio placenta are: uterine tenderness or tension ranging from absent or minimal to boardlike, lady partsl bleeding ranging from none or scant to profuse and dark red, increased uterine size, increased uterine tone, high to engaged presenting part, tachypnea, increasingly shallow respirations, tachycardia, hypotension, abdominal tender to touch, proteinuria, oliguria or anuria, vertigo, syncope, confusion, anxiety, facial expressions of pain, cyanosis, diaphoresis, cold, moist skin, dry mucous membranes.
- you should have been able to assess many of these in your patient
- these form the basis for your nursing diagnoses, and
- your goals, and
- nursing interventions
[*]complications include: death of the mother. postpartum vascular spasm, hemorrhage or intravascular clotting, renal failure due to shock, and complications of the baby: death, hypoxia, prematurity, anemia
[*]http://www.merck.com/mmpe/sec18/ch263/ch263b.html?qt=abruptio%20placenta&alt=sh#sec18-ch263-ch263b-1335 - abruptio placentae

if you don't understand prematurity

care of the newborn requires attention to their physiologic age, not the age as counted from the birth date. during gestation, the senses develop at different stages, with touch and taste developing early and vision and hearing developing later. excessive stimulation by light, sound, temperature, or handling can cause poor weight gain, increased episodes of apnea and bradycardia, hypoxic spells, and poor feeding tolerance.
assessment will show the baby may be dehydrated or have excessive weight loss, may not void within first 24 hours of life, may not have any stools within first 24 hours of life, unable to feed or suck, lethargic, will have periods of sleep and awake that don't exceed 4 hours, may have irregular respiratory rates with labored breathing and, signs of stress that include: facial grimacing, holding the hands over the face, irritability, will have uncoordinated movements, stare, look of panic, tremors of the extremities, seizures, irritability, uncoordinated movements, have frequent color changes that include mottling and cyanosis, periodic apnea or tachypnea as well as a look of straining to breathe, hypertonia or hypotonia, flaccid trunk, poor muscle tone, poor posture, oliguria or anuria
http://www.merck.com/mmpe/sec19/ch272/ch272g.html?qt=prematurity&alt=sh - premature infant

i have given you enough information to be able to start working on this assignment for both patients including weblinks to good information in the merck manual. you should verify that the information is correct in your ob textbook. you merely need to verify that your patient had some or all of these symptoms, match them to appropriate nursing diagnoses using a nursing diagnosis reference and develop your nursing interventions. if you do not have a nursing diagnosis reference you can fins some nursing diagnosis help on these two websites: