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Maternal Newborn Nursing

What Should the Nurse Do?

Maternal Newborn NursingWhat Should the Nurse Do?

What Should the Nurse Do?

Alejandra, a 34-year-old pregnant female at 39 weeks’ gestation, arrives at the emergency department of her local hospital accompanied by her husband. She is experiencing regular contractions and reports escalating pain intensity. Alejandra is a gravida 2, para 1, with a history of a previous cesarean section. Alejandra describes her pain as intense and continuous, radiating from her lower abdomen to her lower back. She reports a desire for pain relief to cope with the discomfort of labor contractions. The couple expresses concerns about the potential for a prolonged and painful labor process. Alejandra's first pregnancy resulted in a cesarean section due to breech presentation. She has had a generally uncomplicated prenatal course during this pregnancy, with no significant medical issues. Regular prenatal checkups have shown a healthy fetus with no identified complications. Her vital signs are as follows: blood pressure: 122/78 mm Hg, heart rate: 96 bpm, respiratory rate: 20 breaths per minute, temperature: 98.6° F (37° C), and fetal heart rate: 140 bpm, regular rhythm.
1 .
What nonpharmacologic and pharmacologic pain management solutions can be offered to Alejandra, considering her history and current pain level, and how might involving her husband in the decision-making process enhance the effectiveness of these solutions?
2 .
After implementing pain management strategies, what indicators should the nurse monitor to assess the effectiveness of the interventions, and how might the nurse adjust the plan based on Alejandra's feedback and progress in labor?
Izzy, a 29-year-old pregnant female at 38 weeks’ gestation, arrives at the maternity unit with her partner. She expresses anxiety about the upcoming birth and is seeking information about pain management options. Izzy reports feeling increasingly anxious about the impending labor and is particularly concerned about managing pain during childbirth. She is open to various pain relief options but expresses a desire for detailed information about the advantages and disadvantages of different anesthesia methods. Izzy has a history of generalized anxiety disorder managed with psychotherapy and occasional low-dose benzodiazepines. Prenatal checkups have revealed a healthy pregnancy with an uncomplicated prenatal course, and there are no known contraindications to anesthesia. Vital signs are as follows: blood pressure: 118/76 mm Hg, heart rate: 92 bpm, respiratory rate: 22 breaths per minute, and temperature: 98.5° F (36.9° C).
3 .
Given Izzy's history of anxiety and her expressed desire for detailed information, what hypotheses can be prioritized regarding her pain management preferences, and how might addressing her anxiety be prioritized in the overall plan of care?
4 .
How should the nurse initiate the education and preparation process for Izzy regarding anesthesia options, and what steps should the nurse take to ensure her understanding and alleviate her anxiety as much as possible?

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