Post Partum HESI Example

 Post Partum HESI Case Study Essay


Prior to stopping the 4 Pitocin (oxytocin), which examination is most important for the health professional to obtain? A) Vital symptoms.


Vital sign examination is important ahead of discontinuing the Lactated Ringer's since the principal IV plays a role in the maintenance of cardiovascular stableness.

B) Oral discharge.

Responses: INCORRECT

Expulsion of minimal shiny red vaginal discharge is normal after delivery. It is difficult for the registered nurse to ascertain customer stability basically by evaluating the genital discharge and estimating levels of vaginal loss of blood.

C) Uterine firmness.

Feedback: CORRECT

Pitocin is a hormone accustomed to stimulate uterine contractions and prevent hemorrhage from your placental internet site. Prior to stopping the 4, it is most important to ensure that the uterus is contracting simply by assessing fundal firmness. В

D) Oral intake.


Analysis of common fluid intake is important once determining if perhaps additional 4 fluids are indicated, however it is not really the initially priority.

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installment payments on your

What is the priority nursing medical diagnosis for Jessica, who is experiencing residual associated with epidural anesthesia? A) Risk for infection.


The lack of feeling below the waistline caused by the residual effects of epidural anesthesia would not pose virtually any real danger of disease, because epidural side effects are unrelated to the mechanisms of infection transmitting or advancement.

B) Exposure to possible injury.

Opinions: CORRECT

Epidural inconsiderateness causes momentary loss of non-reflex movement and muscle durability in the reduce extremities. Critical injury could be incurred if Marie efforts to get up on her personal, because her legs will probably be unable to preserve her weight. The medical priority is usually to ensure her safety by simply implementing make use of all four side-rails and educating her not to get out of bed for the first time without assistance.

C) Damaged physical range of motion.


Marie's impaired physical mobility is definitely temporary and is not likely to cause difficulties resulting in long term immobility.

D) Altered urinary elimination.

Responses: INCORRECT

While the epidural anesthesia might temporarily lessen Marie's ability to void under your own accord, this is usually fixed within six hours. Marie should be watched for urinary fullness through the period that she is not able to sense the necessity to void, yet this concern is secondary to consumer safety.

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Precisely what is the concern nursing action to address Marie's needs associated with the restore of her 4th level perineal laceration? A) Give prescribed mouth pain medicine and stool softener. Opinions: INCORRECT

Marie does not have sensation listed below her waistline because of the recurring effects of the epidural ease. She doesn't need pain medicine at this time. Excrement softener is generally administered within 24 hours of delivery, but it is not only a priority currently.

B) Educate proper and frequent use of the peri-bottle.


It is important for the nurse to instruct Marie in measures to stop infection, such as frequent and proper perineal hygiene methods during the following birth period. Nevertheless , this instructing is not really a priority currently. Marie is exhausted (therefore not receptive to teaching), and she's unable to stand up to the bathroom to emptiness (epidural anesthesia). The more ideal time to teach use of a peri-bottle can be while supporting Marie after she is able to get up and void in the bathroom.

C) Apply perineal ice bags consistently to get the initially 24 to 48 hours. Opinions: CORRECT

Topical perineal ice packages cause neighborhood vasoconstriction, causing decreased swelling and tissues congestion, and also promoting convenience. The application of snow packs is the priority medical action to get the initially 24 to 48 hours, which can be the period the tissue is most vulnerable to inflammation resulting...


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