Amelia Sung- Shoulder Dystocia,WITH VERIFIED ANSWERS GRADED A.

Documentation Assignments 1. Document the fetal status and the progression of Ms. Sung’s labor from the time you took over care of Ms. Sung until the provider takes her to the delivery room. The patient’s vital signs ...

Documentation Assignments 1. Document the fetal status and the progression of Ms. Sung’s labor from the time you took over care of Ms. Sung until the provider takes her to the delivery room. The patient’s vital signs were within normal limits as follows- HR 89, pulse present, BP 140/82, respirations 17, SpO2 97%, temp 37 and FHR 121. When I entered the patients room the head was starting to crown. I preformed my assessments and then we started to deliver the baby. Her chest was moving equally and her skin was normal elasticity. I prepared the delivery table, educated the patient and then encouraged her to start pushing. I attached a 100% oxygen with a nonrebreather mask per drs. Orders. The NICU and charge nurse were called to assist. I continued encouraging the patient and then positioned the patient into McRoberts position. The secondary nurse applied suprapubic pressure and the baby’s neck and shoulders were delivered then the baby was delivered. The baby was then handed to the charge nurse for further examination. 2. Document the essential events related to the time of birth, including the activities and interventions from the time of crowning to the complete expulsion of the fetus. The baby’s head was crowing at 2:52, a virginal exam was performed at 5:29, the bassinet was prepared and I checked for the presence of the step stool at 6:51, I then prepared the delivery table at 6:59, I started instructing the patient to push at 7:47, the baby’s head was delivered at 8:49, The baby’s head was retracting at 10:51, I positioned the patient in McRoberts position at 11:11, The babies shoulders were delivered at 11:55, at 12:10 the baby was delivered. 3. Document the application of suprapubic pressure and the response and outcomes. I applied suprapubic pressure at 11:15, the shoulders were delivered at 11:55, then the baby was born at 12:10. The pressure helped to guide the baby out of the mother. 4. Document your communications with the neonatal intensive care unit (NICU) about the impending birth. I called the NICU at the beginning of the simulation because we knew of the possible risk for shoulder dystocia. The NICU and charge nurse were both called to help delivery the baby. Maternity Case 3: Amelia Sung Guided Reflection Questions Opening Questions How did the simulated experience of Amelia Sung’s case make you feel? Once I ran through the simulation once and got an idea of the task I needed to complete I felt comfortable. Describe the actions you felt went well in this scenario. I felt I was able to encourage the patient well in this scenario. Scenario Analysis Questions1 EBP What risk factors specific to shoulder dystocia were identified in Amelia Sung’s case? The baby’s head was delivered without the shoulders which is a key indication of shoulder dystocia. PCC/I Prioritize your nursing actions for Amelia Sung based on your assessment. I should have called the NICU and charge nurse earlier in the simulation and I should have applied the nonrebreather oxygen mask right after checking vital signs. EBP List potential problems for Amelia Sung and her baby related to the shoulder dystocia. Maternal obesity and diabetes. There is a risk for postpartum hemorrhage because of the need of manipulation. T&C List the interprofessional health care team that should be involved in Amelia Sung’s case. NICU and charge nurse. S/QI/I Consider what points might be included in a safety checklist for shoulder dystocia. High maternal birth weight, diabetes, more than 42 weeks of gestation. Concluding Questions Reflecting on Amelia Sung’s case, were there any actions you would do differently? Explain. I would have called for assistance earlier in the simulation and applied the nonrebreather face mask after taking initial vital signs. Describe how you would apply the knowledge and skills that you obtained in Amelia Sung’s case to an actual patient care situation. I would do the same steps I did in this simulation taking care of a patient in real life.