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OB NURS 340 Case Studies-reviewed by experts 2021

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NURS 340 Case Studies Instructions: Complete and return all seven case studies in this assignment by 4:30 PM on April 20, 2017. Chapter 23, Nursing Care of the Newborn With Special Needs I. Brenda is a nurse in a special care nursery. A 16-year-old girl had been admitted to the emergency department earlier that morning with complaints of excruciating back pain and nausea. She was diagnosed as being in labor and transferred to the labor and delivery unit. She was apparently unaware of the pregnancy. She received no prenatal care and cannot remember the exact date of her last menstrual period. An ultrasound determined the infant to be approximately 5 lb. All attempts to stop labor are unsuccessful, and a baby girl is delivered. The newborn is placed on the open bed warmer for the team to assess. They observe poor muscle tone, labored respirations, heart rate <100. The infant is not crying. The infant receives stimulation by drying with a warm blanket and oxygen via bag and mask per the respiratory therapist at just prior to 1 minute of age. The infant’s color is blue at 1 minute of age and her Apgar score is 7. The infant’s tone improves, and she begins to pull her arms and legs to midline. Her color improves quickly with blow-by oxygen and the respiratory therapist slowly backs off the oxygen. The infant receives an Apgar score of 9 at 5 minutes of age. The baby’s physical appearance includes the following: head a little larger than body size, numerous veins visible under skin, plantar creases on half of foot sole, ears are formed and soft with little cartilage, nipples aren’t well defined, labia majora smaller than labia minora. a. What equipment would Brenda check to ensure that it was present and working properly for the delivery? Why might she need this equipment? Brenda would want to ensure that the fetal heart rate monitoring equipment because then she would be able to assess fetal heart rate, as well as uterine contractions. This would help the nurse better assess the situation and help her make wiser interventions/ adjustments. Another thing that would have been beneficial would be to have Betamethasone ready in the orders by the physician. This is because this baby is definitely known to become a premature baby, and babies born prematurely are at risk for having underdeveloped lungs. Betamethasone would help you strengthen the fetus’s. b. Based on the physical assessment and response to resuscitation, what would you determine this infant to be: preterm, term, or postterm? Why? This infant is preterm. You can conclude this from the infant’s overall assessment: labored breathing, cyanotic, no crying, and lacks stimulation. c. Once the infant is stable, what course of action should Brenda take next? Why? What problems should she anticipate?

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