Case Study Presentation

Intervention #1

Have a medical translator or a family member who speaks proficient English explain to the patient how serious a uterine rupture can be and the consequences of a uterine rupture.

Rationale:

The patient are more receptive to important information presented her own language, especially in an intimidating environment (Karliner et al., 2007)

Intervention #1

Intervention #2

Educate the patient on how to avoid being at risk for uterine rupture for the future pregnancies.

Rationale:

Understanding how to decrease her risk of uterine rupture will help decrease her chances of being at risk in the future (Davidson et al., 2016)

Intervention #2

Intervention #3

Provide patient with physical handouts on uterine rupture.

Rationale:

During contractions, the patient cannot fully focus and comprehend materials being presented to her. Giving the patient physical handouts to take home allows her to review the information later (Arnold et al., 2008)

Intervention #3

Evaluation

The goal has not been met due to the mother having frequent painful contractions, which is not the optimal situation for education.

Evaluation

Intervention #1

Educate the patient on why she is at risk for uterine rupture.

Rationale:

An understanding of her risk and how serous uterine rupture is will prompt her to be more cautious with this pregnancy and avoid putting herself at risk for future pregnancies.

The risk for uterine rupture increases with each c-section due to scarring of the uterine muscle (Davidson et al, 2018).

Intervention #1

Intervention #2

Educate patient on and monitor the maternal symptoms of uterine rupture (constant abdominal pain, uterine tenderness, cessation of contractions, & hematuria).

Rationale:

Educating the mother on the symptoms she may experience if she has a uterine rupture will help us as the nurse monitor her status to ensure her safety and early intervention (Davidson et al., 2018)

Intervention #2

Intervention #3

Maintain ongoing uterine assessments for fetal symptoms of uterine rupture (nonreassuring fetal heartrate, variable or late decelerations, followed by bradycardia).

Rationale:

Maintaining ongoing uterine assessments and carefully monitoring for fetal symptoms of uterine rupture will allow us to intervene early if needed (Davidson et al., 2018)

Intervention #3

Evaluation

The goal was unable to be evaluated due to the shift ending before the mother gave birth.

Evaluation

Intervention #1

Learn patient needs and being attentive to nonverbal cues.

Rationale:

Learning the patient's needs and nonverbal cues is important when there is a communication to ensure quality of care and that her needs are met (Shyve, 2017)

Intervention #1

Intervention #2

Provide an alternative means of communication for times when an interpreter or family member is not present.

Rationale:

Providing a communication medium with both a patient's primary language and English on it will help the patient express her needs and how she is feeling (Shyve, 2007).

Intervention #2

Intervention #3

Try to simplify questions or rephrase them to yes or no questions.

Rationale:

Patients can get frustrated when they cannot communicate their needs in a simple manner. With the patient currently in labor, asking simple questions would be most effective (Davidson et al., 2018)

Intervention #3

Evaluation

This goal was met as evidenced by patient verbalizing that she did not need anything else.

Evaluation

Intervention #1

Provide translation cards for the patient with English on one side and their primary language on the other side.

Rationale:

Giving the patient cards with both languages on it will help the patient communicate more effectively as well as the opportunity to familiarize themselves with the English translation (Mojarradi, 2014).

Intervention #1

Intervention #2

Obtain a professional translator to ensure effective communication between the care team and the patient.

Rationale:

Having a translator ensures the best patient care is being provided because information can be relayed more accurately (Karliner, 2007)

Intervention #2

Intervention #3

Provide a picture board as a communication tool.

Rationale:

Visual tools are highly effective in a health setting and can help communicate health risk factors, needs, and symptoms (Garcia-Retamero & Cokely, 2013)

Intervention #3

Evaluation

Unable to evaluate because the shift was over before the patient was discharged.

Evaluation

Intervention #1

Collaborate with the patient about possible methods to reduce pain.

Rationale: Including the patient in her care will help individualize the interventions carried out to reduce her pain. The patient knows her body best and therefore will have an idea of what would help reduce her pain (Davidson et al., 2018)

Intervention #1

Intervention #2

Educate the patient on non-pharmacologic ways to decrease pain.

Rationale: Educating and offering the patient on non-pharmacologic ways to relieve pain can open up more options for the patient to choose from to decrease her pain that she may not have thought about (Davidson et al., 2018).

Intervention #2

Intervention #3

Get rid of additional stressors or sources of discomfort whenever possible.

Rationale:

Patients may experience an exaggeration in pain or a decreased ability to tolerate painful stimuli if environmental, intrapersonal, or intrapsychic factors are further stressing them (Davidson et al., 2018).

Intervention #3

Evaluation

The goal was met as evidenced by the patient verbalizing and demonstrating deep breathing, heating packs, and repositioning to alleviate her pain.

Evaluation

Intervention #1

Administer analgesics as ordered based on patient's reporting of pain.

Rationale:

Depending on the patient's level of pain, physicians can prescribe analgesics to alleviate the pain. The nurse's role is to assess the pain level and administer as ordered (Davidson et al., 2018)

Intervention #1

Intervention #2

Provide rest periods and cluster care activities.

Rationale:

Pain may become exaggerated as a result of exhaustion. Pain may result in fatigue, which may result increase the pain (Davidson et al., 2018)

Intervention #2

Intervention #3

Provide nonpharmacologic methods of pain alleviation such as heat therapy, massage therapy, and deep breathing coaching.

Rationale:

Some nonpharmacologic methods may reduce pain moderately and often result in a more positive birth experience for the mother. It's important to personalize the pain management methods used for each woman’s wishes, needs, pain tolerance, and anticipated duration of labor.

(Simkin & Ohara, 2002)

Intervention #3

Evaluation

The goal was met as evidenced by the patient rating her pain as a 2 from a 5 and no longer grimacing or moaning.

Evaluation