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Maternity Case 2: Brenda Patton – vSim for Nursing – Quizlet

In what order would the nurse complete the steps below? 1.) Verify the prover’s order 2.) Check the patient’s allergy status 3.) Confirm patient entity with …

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View Brenda Patton – Feedback Log & Score.pdf from PSYCH MISC at SUNY Westchester Community College. Date of Completion May 15, 2020 3:14 PM Brenda Patton …

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Date of Completion Nov 04, 2019 9:10 PM Brenda Patton Age: 18 years Diagnosis: Rupture of membranes. Labor assessment Score Feedback Log 0:00 You arrived at …

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complex 6 – Free download as Word Doc (.doc / .docx), PDF File (.pdf), Text File (.txt) or read online for free. brenda paton vsim.

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• Author: 익명의가노
• Views: 조회수 5,257회
• Likes: 좋아요 32개
• Date Published: 2021. 8. 25.
• Video Url link: https://www.youtube.com/watch?v=OWM_xOjOvq8

What should be included in the priority teaching for Brenda Patton?

PCC What should be included in the priority teaching for Brenda Patton? -“We can see that you are in active labor. We will be monitoring you and will do some diagnostic tests to make sure everything is fine with you and your baby.”

What are possible complications that a newborn can acquire from the mother with a positive GBS status during the birthing process?

Early-onset GBS can cause pneumonia, sepsis or meningitis. If you have GBS, you can pass this kind of infection to your baby. But treatment with antibiotics during labor and birth can help prevent your baby from getting it. About half of all GBS infections in newborns are early-onset.

What are the possible complications that a newborn can acquire from the mother with a positive GBS status during the birthing process select all that apply quizlet?

What are the possible complications that a newborn can acquire from the mother with a positive GBS status during the birthing process? Pneumonia, sepsis, meningitis.

What findings indicate fetus is tolerating labor?

A baby that meets the criteria based on the available information from the fetal monitor is most likely receiving enough oxygen. His/her baseline heart rate is between 110 and 160 beats per minute with moderate variability (fluctuations between beats), and no variable or late decelerations.

What are the possible complications that a newborn can acquire from the mother?

If the mother becomes infected then, it can cause serious problems such as heart disease, brain damage, deafness, visual impairment, or even miscarriage. Infection later in the pregnancy may lead to less severe effects on the fetus but can still cause problems with the infant’s growth or development.

What happens if you test positive for strep B while pregnant?

If you test positive for group B strep, you’ll be given IV antibiotics as soon as active labor begins or your water breaks, whichever comes first. If you have a cesarean section, you’ll be given antibiotics anyway, and these antibiotics will be adequate to treat the group B strep.

What does it mean if I test positive for group B strep?

A positive test indicates that you carry group B strep. It doesn’t mean that you’re ill or that your baby will be affected, but that you’re at increased risk of passing the bacteria to your baby.

What does GBS positive mean?

If a test finds GBS, the woman is said to be “GBS-positive.” This means only that she has the bacteria in her body — not that she or her baby will become sick from it. GBS infection in babies is diagnosed by testing a sample of blood or spinal fluid. But not all babies born to GBS-positive mothers need testing.

What are the nursing interventions to perform during active labor?

These interventions can include bed rest/recumbent position, electronic fetal monitoring (EFM), limited oral intake during labor, frequent vaginal exams, inductions/augmentations, amniotomy, regional anesthesia, catheterization, ineffective pushing, episiotomy, instrumental vaginal birth, and cesarean surgery.

When was the diagnosis of shoulder dystocia made in MS Sung’s case?

What was the diagnosis of shoulder dystocia made in Ms. Sung’s case? When the newborn’s head delivered without the delivery of the neck and body. After the fetal head emerges, the nurse notes that the fetal heart rate is 90 beats per minute with minimal variability.

What might result if a woman drank and smoked during the fifth week of gestation?

What might result if a woman drank and smoked during the fifth week of gestation? Since the woman is in the fifth week, this is the stage that is most susceptible to birth defects and miscarriage.

Which Symptoms are expected changes during pregnancy select all that apply?

Breast changes (swollen), nausea and vomiting, amenorrhea, frequent urination, fatigue, uterine enlargement, quickening, linea nigra, melasma, and striae gravidarum are the presumptive signs of pregnancy.

During which stage of childbirth does the fetus emerge from the womb quizlet?

Stage 1: The first stage of labor begins with contractions of the uterus and dilation of the opening of the cervix to 10 centimeters (about four inches). Stage 2: The second stage of labor begins when the baby’s head moves through the cervix and into the birth canal. This stage ends with the delivery of the baby.

How many weeks do u carry a baby?

Pregnancy lasts for about 280 days or 40 weeks. A preterm or premature baby is delivered before 37 weeks of your pregnancy. Extremely preterm infants are born 23 through 28 weeks.

Maternity Case 2: Brenda Patton – vSim for Nursing Flashcards

A primigravida is admitted to labor and delivery. A review of her prenatal records revealed a urinanalysis with a negative WBC count, RBC count, leukoesterase, and nitrates, and positive glucose and ketones; a serology report that was positive for hepatitis B surface antigens; and a microbiology report positive for GBS. For which of the following reasons would the nurse initiate intrapartum prophylaxis antibiotics?

Brenda Patton Documentation

Maternity Case 2: Brenda Patton

Guided Reflection Questions

Opening Questions How did the simulated experience of Brenda Patton’s case make you feel?

The simulated experience of Brena Patton’s case was pretty straight forward.

Describe the actions you felt went well in this scenario.

The actions that I felt went well in this scenario was assessing the patient, asking her for her pain level, gave comfort measures, recognizing she had pain and tried to make her as comfortable as possible. I also was able to educate her and make her and her significant other less anxious. I was able to administer her medications easily.

Scenario Analysis Questions 1 EBP What complications can occur if group B streptococcus is not treated?

The complications can occur if group B streptococcus is not treated include: skin infection, infection of the bloodstream, pneumonia, bone and joint infections, endocarditis, and meningitis.

PCC What should be included in the priority teaching for Brenda Patton?

-“We can see that you are in active labor. We will be monitoring you and will do some diagnostic tests to make sure everything is fine with you and your baby.”

-Explain that she had a ruptured membrane and what this includes.

Her results came back as GBS positive. Group B Streptococcal continues to be one of the leading infections of infant mortality abd morbidity in the US. The primary risk factor is maternal intrapartum colonization, and your screening revealed that you were positive. Prophylactically we will give you Penicillin to reduce the chances of the baby contracting the infection.

-Vital signs within normal range.

-Patient received education regarding that the medication would not harm the fetus which allowed her to comfortably give me permission to administer her the medication for her condition.

T&C What key elements would you include in the handoff report for this patient? Consider the situation-background-assessment-recommendation (SBAR) format.

1

From vSim for Nursing | Maternity and Pediatric. © Wolters Kluwer Health.

-Her History: Brenda Patton, an 18-year old Caucasian female, G1P0 at 38 2/7 weeks of gestation is admitted to the labor and birthing unit for labor assessment. She states her water may have broken earlier this morning and she thinks she is in labor. AmniSure was +. Vaginal exam reveals 50% effacement of cervix, cervical dilation 4 cm, and fetus at -2 station. Her boyfriend is present and Ms. Patton’s mother was called earlier by Ms. Patton to inform her of her admission. The provider has been notified and prenatal records have been pulled. The lab report indicates that the patient’s group B strep vaginorectal cultyre taken at 36 weeks was positive. The patient wishes to have a natural birth without medication. Admission intrapartum orders have been initiated, initial labs have been drawen, and a saline lock has been placed.

Ms. Patton’s vital signs: HR: 88, Pulse: Present, BP 117/70 mm Hg, Respirations: 20, normal breathing and chest moving equally. Ms. Patton is in an appropriate conscious state, and her SpO2 is 97%. Her temperature is 99 F. EFM showed baseline, and fetal heart rate was 141.

Assessment: No obvious airway obstruction and there is normal elasticity of the skin. Her color is normal and she is not sweating. Next I examined Ms. Patton’s chest. She is breathing at 20 breaths per minute and her chest moving equally. Normal elasticity of the skin and skin color is normal. She is not sweating. Ms. Patton’s arms were normal elasticity and her skin color was normal and she was not sweating. There was nothing else to examine on her arms. Ms. Patton’s abdomen and pelvis were examined next. Leopold’s maneuvers were performed and the fetus is in longitudinal lie, in vertex presentation. Nothing to be examined on Ms. Patton’s legs. No pitting edema and her deep tendon reflexes were normal, 2+.

Medication: Ms. Patton received

Penicillin 5 million units IVPB (piggyback).

Promethazine 12 mg IVPB (piggyback) every 4 hours PRN (for nausea/vomiting).

Education:

Patient was educated. See question above.

S/QI Based on your experience with Brenda Patton’s case, reflect on possible nursing actions for enhanced safety and quality improvement.

Educating her about her meds she was receiving, the education about the equipment we were using on her (pulse ox, BP device, fetal monitor), advised her of position changes every hour, educated her about her ruptured membranes, made sure to do her head to toe assessment, handled her pain with comfort measures, asking her her name and date of birth and any allergies, etc.

From vSim for Nursing | Maternity and Pediatric. © Wolters Kluwer Health.

Group B strep infection

Group B streptococcus (also called Group B strep or GBS) is a common type of bacteria (tiny organisms that live in and around your body) that can cause infection. Usually GBS is not serious for adults, but it can hurt newborns.

Many people carry Group B strep bacteria and don’t know it. It may never make you sick. GBS in adults usually doesn’t have any symptoms, but it can cause some minor infections, like a bladder or urinary tract infection (UTI).

While GBS may not be harmful to you, it can be very harmful to your baby. If you’re pregnant, you can pass it to your baby during labor and childbirth.

About 1 out of 4 pregnant women (25 percent) carry GBS bacteria. The best way to know if you have GBS is to get tested. If you do have GBS, though, there’s good news: your health care provider can give you treatment during labor and birth that protects your baby from GBS.

How do you get GBS?

GBS bacteria live in the intestines and the urinary and genital tracts. It lives in the body naturally. As an adult, you can’t get it from food, water or things you touch. You can’t catch it from another person, and you can’t get it from having sex.

How do you know if you have GBS?

Your provider tests you for GBS at 35 to 37 weeks of pregnancy. Testing for GBS is simple and painless. Your provider takes a swab of your vagina and rectum and sends the sample to a laboratory. Your test results are usually available in 1 to 2 days.

Your provider also can use some quick screening tests during labor to test you for GBS. But these should not replace the regular GBS test that you get at 35 to 37 weeks of pregnancy.

How can you protect your baby from GBS?

If your GBS test at 35 to 37 weeks shows you have the infection, your provider gives you medicine called an antibiotic during labor and birth through an IV (through a needle into a vein). You also may be treated if you have any risk factors for GBS and you don’t know your GBS test results or you haven’t been tested yet. Treatment with antibiotics helps prevent your baby from getting the infection.

Penicillin is the best antibiotic for most women. Another antibiotic called ampicillin also can be used. These medicines usually are safe for you and your baby. But some women (up to 1 in 25 women, or 4 percent) treated with penicillin have a mild allergic reaction, like a rash. About 1 in 10,000 women have a serious allergic reaction that needs to be treated right away. If you’re allergic to penicillin, your provider can treat you with a different medicine.

If your test shows you have GBS, remind your health care providers at the hospital when you go to have your baby. This way, you can be treated quickly. Treatment works best when it begins at least 4 hours before childbirth.

If you have GBS and you’re having a scheduled cesarean birth (c-section) before labor starts and before your water breaks, you probably don’t need antibiotics.

It’s not helpful to take oral antibiotics before labor to treat GBS. The bacteria can return quickly, so you could have it again by the time you have your baby.

If you have GBS, what are the chances that you can pass it to your baby?

If you have GBS during childbirth and it’s not treated, there is a 1 to 2 in 100 chance (1 to 2 percent) that your baby will get the infection. The chances are higher if you have any of these risk factors:

Your baby is premature. This means your baby is born before 37 weeks of pregnancy.

Your water breaks (also called ruptured membranes) 18 hours or more before you have your baby.

You have a fever (100.4 F or higher) during labor.

You’ve already had a baby with a GBS infection.

You had a UTI during your pregnancy that was caused by GBS.

If you have GBS and you’re treated during labor and birth, your treatment helps protect your baby from the infection.

If your baby gets GBS, do signs of infection or other problems show up right after birth?

Not always. It depends on the kind of GBS infection your baby has. There are two kinds of GBS infections:

Early-onset GBS: Signs like fever, trouble breathing and drowsiness start during the first 7 days of life, usually on the first day. Early-onset GBS can cause pneumonia, sepsis or meningitis. If you have GBS, you can pass this kind of infection to your baby. But treatment with antibiotics during labor and birth can help prevent your baby from getting it. About half of all GBS infections in newborns are early-onset. Late-onset GBS: Signs like coughing or congestion, trouble eating, fever, drowsiness or seizures usually start when your baby is between 7 days and 3 months old. Late-onset GBS can cause sepsis or meningitis. If you have GBS, you can pass this kind of infection to your baby during or after birth. Treatment with antibiotics during labor and birth does not prevent late-onset GBS. After birth, your baby also can get GBS from other people who have the infection.

What problems can GBS cause in newborns?

Babies with a GBS infection can have one or more of these illnesses:

Meningitis, an infection of the fluid and lining around the brain

Pneumonia, a lung infection

Sepsis, a blood infection

Pneumonia and sepsis in newborns can be life-threatening.

Most babies who are treated for GBS do fine. But even with treatment, about 1 in 20 babies (5 percent) who have GBS die. Premature babies are more likely to die from GBS than full-term babies (born at 39 to 41 weeks of pregnancy).

GBS infection may lead to health problems later in life. For example, about 1 in 4 babies (25 percent) who have meningitis caused by GBS develop:

Cerebral palsy (A group of disorders that can cause problems with brain development. These problems affect a person’s ability to move and keep their balance and posture.)

Hearing problems

Learning problems

Seizures

If your baby has a GBS infection, how is he treated?

It’s important to try and prevent a newborn from getting GBS. But if a baby does get infected with early-onset GBS or late-onset GBS, he is treated with antibiotics through an IV.

If you’re treated for GBS during labor, does your baby need special treatment?

Probably not. But if you have a uterine infection (an infection in your uterus) during labor and birth, your baby should be tested for GBS. Your baby’s provider can treat your baby with antibiotics while you wait for the test results.

Can GBS cause problems for mom during and after pregnancy?

GBS can cause a uterine infection during and after pregnancy. Symptoms of a uterine infection include:

Fever

Pain in your belly

Increased heart rate (During pregnancy, it also can cause your baby’s heart rate to increase.)

If you have a uterine infection, your provider can give you antibiotics, and the infection usually goes away in a few days. Some women have no symptoms, so they don’t get treatment. Without treatment, infection during pregnancy may increase your chances of:

Premature rupture of the members – When the amniotic sac breaks after 37 weeks of pregnancy but before labor starts

Preterm labor – Labor that happens too early, before 37 weeks of pregnancy

Stillbirth – When a baby dies in the womb after 20 weeks of pregnancy

If you’re treated for GBS during labor and birth, you probably won’t get a uterine infection after your baby is born.

GBS also can cause a UTI during pregnancy. A UTI can cause fever or pain and burning when you urinate. Sometimes a UTI doesn’t have any symptoms. If you have a UTI, you may find out about it from a urine test during one of your prenatal visits.

If you have a UTI caused by GBS, your provider gives you antibiotics to take by mouth during pregnancy. You also get antibiotics through an IV during labor and birth, because you may have high levels of GBS in your body.

Is there a vaccine for GBS?

No. But researchers are making and testing vaccines to prevent GBS infection in mothers and their babies.

More information

Centers for Disease Control and Prevention (CDC)

Last reviewed: November, 2013

Maternity Case 2: Brenda Patton – vSim for Nursing Flashcards

A primigravida is admitted to labor and delivery. A review of her prenatal records revealed a urinanalysis with a negative WBC count, RBC count, leukoesterase, and nitrates, and positive glucose and ketones; a serology report that was positive for hepatitis B surface antigens; and a microbiology report positive for GBS. For which of the following reasons would the nurse initiate intrapartum prophylaxis antibiotics?

SOLUTION: Brenda patton vsim feedback log and score

0:13 You washed your hands. To maintain patient safety it is importan t to w ash your

hands as soon as you enter the roo m.

0:47 You identified the patient. To maintain patient safety it is important that you

quickly identi fy the patient.

0:57 You asked if the pa tient was allergic<> t o anything. She

replied: ‘No , I am not allergic to anything.’

1:04

Patient status – Heart rate: 90. Pulse: Pre sent. Blood pressure: 120/71 mm Hg.

Respiration: 20. Conscious state: Appropr iate. SpO2: 97%. Te mp: 37 C. E FM: Baseline.

Fetal heart rate: 149.

1:08 You asked the patient if she had any pain. She replied : &a pos;Yes, I have some

pain.’

1:19 You asked: How ba d is the pain? (In p ain) She replied: &apos ;Not too bad;

it’s about a 2 between contractio ns.’

1:40 You looked for normal breathing. She is breathing a t 20 breath s per minute. The

chest is moving equally.

2:04

Patient status – Heart rate: 90. Pulse: Pre sent. Blood pressure: 120/71 mm Hg.

Respiration: 19. Conscious state: Appropr iate. SpO2: 98%. Te mp: 37 C. E FM: Baseline.

Fetal heart rate: 141.

2:08 You attached the This was indicated

by order.

2:21 You checked the radial pulse. The pulse is strong, 90 per minute and regular. It is

correct to asse ss the patient&apo s;s vital signs.

2:48 You measured the at 120/72 mmHg.

It is appropriate to monitor the patient by measuring the blood pressure.

3:04

Patient status – Heart rate: 89. Pulse: Pre sent. B lood pressure: 119/70 mmHg .

Respiration: 19. Conscious state: Appropr iate. SpO2: 98%. Te mp: 37 C. E FM: Baseline.

Fetal heart rate: 140.

3:13 You ch ecked the ;temperature<> at the mou th. The

temperature w as 3 7 C.

3:34 You examined t he patien t’s skin. There is normal elasticity o f the skin. Her

color is normal and she is not s weating.

3:58 You assessed t he patient&apo s;s IV. The si te had no redness, swelling,

infiltration, bleeding, or drainage. The dressing was dry and intact. This is

correct. Assessing any IVs the patient has is always important.

4:04

Patient status – Heart rate: 89. Pulse: Pre sent. Blood pressure: 119/71 mm Hg.

Respiration: 19. Conscious state: Appropr iate. SpO2: 98%. Temp: 37 C. EFM: Baseline.

Fetal heart rate: 140.

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