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Postpartum Hemorrhage

Tina Nelson delivered a healthy male infant 6 hours ago. She had a midline episiotomy. This is her third pregnancy. She is now a G3P3003. She had an epidural block for her labor and delivery. She is now admitted to the postpartum unit.

  1. What is important to note in the initial postpartum assessment? Include at least 5 assessments. Why is it important to assess for these things and what do the findings mean?
  2. What are potential indications of a postpartum hemorrhage? List at least three indications.
  3. What would you do if you found a boggy uterus?
  4. What are the normal dose range and administration routes for oxytocin?

a. Induction/Stimulation of Labor:
b. Postpartum Hemorrhage:
c. Incomplete/Inevitable Abortion:

  1. What are the contraindication, side effects, and adverse effects of oxytocin?
  2. Complete the following dosage calculation:
    a. The physician has ordered 1000 mL Lactated Ringers (LR) with 10 units IV oxytocin. Begin at 1 mU/min and then increase by 1 mU/min every 30 minutes until regular contractions occur. Maximum dose is 20 mU/min.
    i. What is the beginning IV rate in mL/hr?
    ii. What is the maximum IV rate in mL/hr?
  3. What is the indication for Methergine, and what is a normal dose?
    a. What are contraindications for Methergine?
    b. What are the adverse reactions or possible side effects for Methergine?
  4. What interventions would you anticipate in the event of a postpartum hemorrhage (independent and dependent nursing interventions)? List at least 5 interventions in order of priority.

Sample Solution

this exposition I will examine the associations between initiative, inspiration and cooperation speculations, how they interface with training in associations and their impediments, offering arrangements where difficulties emerge. The exposition means to reach inferences on the appropriateness of Fiedler's Contingency Theory of Leadership, Tuckman's Model of Group Development, Belbin's Team Theory, and Herzberg's Two Factor Theory by and by, and how intricacies like power and impact shape how they can be applied to best suit what is going on a pioneer faces. Initiative Contingency based hypotheses of administration recommend that there is no right or most ideal way to lead a gathering, or association, because of the critical number of limitations on a circumstance (Flinsch-Rodriguez, 2019). Fiedler, in his Contingency Theory of Leadership (Fiedler, 1967), proposes that the adequacy of a gathering is subject to the administration styles of the pioneer and their favourability to the circumstance. A large part of the hypothesis is laid out around the most un-favored associate scale (LPC). The LPC expects to evaluate a potential chiefs way to deal with an errand on a size of relationship spurred to task inspired, where the pioneer fits on the scale permits what is happening to be derived, and accordingly permits the distinguishing proof of reasonable pioneers for undertakings. The favourableness of the circumstance relies upon three qualities: pioneer part relations, the help and trust the pioneer as from the gathering; task structure, the lucidity of the undertaking to the pioneer; and positional power, the power the pioneer needs to evaluate a gatherings execution and give prizes and disciplines (Fiedler, 1967). On the off chance that the pioneers approach matches what is expected from going on, achievement is anticipated for the gathering. Fiedler's possibility model offers an extremely grave categorisation of administration, obviously characterizing which circumstances endlessly won't bring about progress for an expected pioneer. At the senior administration level of a hierarchal design inside an association the hypothesis can be applied uninhibitedly, initially because of the simplicity at which people can be supplanted in the event that their LPC score doesn't match that expected of the circumstance (Pettinger, 2007). Besides, and in particular, is to guarantee that the senior administration are ideally suited to effectively lead the association. In any case, further down the progressive system Fielder's possibility hypothesis starts to hold significantly less pertinence, it becomes illogical according to a hierarchical viewpoint because of the quantity of individuals at this degree of administration. The coordinated factors of coordinating the pioneer with their most un-favored colleague is difficult to reliably accomplish, so a more continuum based approach is required. Figure 1: Chelladurai's Multi-Dimensional Model of Leadership (Miller and Cronin, 2012) There are other possibility hypotheses that give a more continuum based approach like Redding's hypothesis of administration and the executives, but Fielder's portrayal of how situational factors influence the authority style expected for the circumstance is incredibly helpful in grasping the basics of initiative (Pettinger, 2007). Chelladurai in his Multi Dimensional Model of Leadership, develops a lot of Fiedler's hypothesis however in a continuum based approach, in which the pioneer can adjust their leadershi
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