Case Study of Amanda Stevens, 26 Years Old and Baby Grace Breastfeeding Newborn Unfolding Reasoning 100%Solved.

Case Study of Amanda Stevens, 26 Years Old and Baby Grace Breastfeeding Newborn Unfolding Reasoning 100%Solved. Amanda Stevens, 26 years old and baby Grace Primary Concept Reproduction Interrelated Concepts (In order of emphasis) • Pain • Patient Education • Clinical Judgment NCLEX Client Need Categories Percentage of Items from Each Category/Subcategory Covered in Case Study Safe and Effective Care Environment • Management of Care 17-23% • Safety and Infection Control 9-15% Health Promotion and Maintenance 6-12% Psychosocial Integrity 6-12% Physiological Integrity • Basic Care and Comfort 6-12% • Pharmacological and Parenteral Therapies 12-18% • Reduction of Risk Potential 9-15% • Physiological Adaptation 11-17% Case Study of Amanda Stevens, 26 Years Old and Baby Grace Breastfeeding Newborn Unfolding Reasoning 100%Solved. History of Present Problem: Amanda Stevens is a 26-year-old female, G1 P1, accompanied by her husband, Brad. She presented to the maternity unit complaining of contractions every five minutes for the past three hours. She was dilated to 6 cm, 50% effaced, -2 station and admitted for labor. Brad was very supportive throughout her labor. She received an epidural for pain control and delivered by spontaneous vaginal delivery (SVD) a baby girl 12 hours later at 39 5/7 weeks gestation. Amanda’s blood type is A+ and is Group B strep (GBS) negative. Baby Grace was 7 pounds 8 ounces (3.4 kg), 20 inches (50.8 cm) long with APGARS of 9 at one minute and 9 at 5 minutes. Delayed cord clamping for one minute occurred and then she immediately went to breast and latched with minimal assist and nursed for ten minutes. Initial newborn assessment was completed with no abnormal findings. Her vital signs at birth were HR: 158, R: 54 T: 98.1 F/36.7 C axillary. Personal/Social History: Amanda and Brad have been married for two years and live 15 miles from the hospital in a small, rural community. Brad is a security guard at a prison located 30 miles from home and Amanda is a preschool teacher for the local preschool in her town. She will be taking eight weeks off from work before returning full time. Amanda’s parents live two hours away and will be coming tomorrow to stay with Amanda for a few days when she and the baby are discharged. Brad’s parents live out of state and will be coming to visit next month. Amanda’s sister lives an hour away and has a toddler and has offered to help Amanda if she needs it. Amanda and Brad just moved to their home six months ago and do not have many friends in the area. What data from the histories are RELEVANT and must be interpreted as clinically significant by the nurse? RELEVANT Data from Present Problem: Clinical Significance: 1. Immediately went to breast and latched for five minutes. 2. No abnormal findings of newborn at birth 1. This is a great sign! Patient may feel confident going forward, but this also may not be a full representation of breastfeeding moving forward. We would want to continue to encourage patient and be prepared to provide support. 2. There are no barriers to breastfeeding with the newborn thus far. RELEVANT Data from Social History: Clinical Significance: 1. Married for 2 years 2. Husband works 30 miles from home 3. Patient is taking off 8 weeks from work 4. Patient’s parents live two hours away – will be staying with patient for a few days after discharge. 5. Husband’s parents will come to visit next month 6. Patient’s sister offered to help if needed, but sister also has toddler 7. Do not have many friends in the area 1. This couple is new to marriage; they may still be settling into life as a married couple, adding extra strain. But they could also be still in the “honeymoon” phase. We have to be prepared to provide support regardless. 2. Once discharged, husband won’t be immediately available for help while he’s at work 3. The patient may desire to breastfeed for an extended period of time and this may make it difficult 4. The patient will have some support once discharged, even when husband is at work 5. There will be additional help 6. Sister has offered help. Sister may also have experience with breastfeeding and might be able to offer support 7. Once parents and in-laws go home, the patient doesn’t have much continuous support.