Amelia Sung Core

MATERNITY CASE 5: AMELIA SUNG (CORE) This study source was downloaded by from CourseH on :42:06 GMT -05:00 Maternity Case 5: Amelia Sung (Core) Documentation Assignments 1. Document Ms. Sung’s admission to the labor unit, including the plan of care and appropriate referrals. ● Sung was admitted 6 hours ago in active labor, she is 39 weeks. On admission she was 4cmdilated, 100% effaced, the fetus is at-1 station and is in vertex position. She is Gravida 2 and with her previous delivery ended with shoulder dystocia which places her at a higher risk or reoccurrence. The NICU has been notified of the potential risk for the fetus and the charge nurse has been notified to assist as needed. 2. Document the essential events related to the time of birth, including the activities and interventions from the time of crowning to the complete expulsion of the fetus. ● From the moment the fetus began to crown, Ms. Sung was encouraged to push during contractions. To assist with shoulder dystocia, Ms. Sung was placed in a lateral tilt. After the baby was delivered, the baby was immediately given to the mother to promote bonding with skin to skin contact. 3. Using the situation-background-assessment-recommendation (SBAR) technique, document your communications with the provider when he or she arrives in Ms. Sung’s room after being called. ● Ms. Sung is a 36-year-old filipino female who presented to the clinic in active labor, she is crowning and is ready for delivery. The fetus is presenting in the vertex position and her previous pregnancy ended with a shoulder dystocia, NICU has been notified of the risk. 4. Document the fetal response to the second stage of labor. ● Fetal heart rate is stable at 120 bpm, moderate fetal heart rate variability, and variable decelerations. Fetal descent has been slow. Maternity Case 5: Amelia Sung (Core) This study source was downloaded by from CourseH on :42:06 GMT -05:00 Guided Reflection Questions Opening Questions How did the simulated experience of Amelia Sung’s case make you feel? ● At first, I was nervous because I didn’t know what to do first, But I made sure I went over the orders well and then I just did what needed to be done. Describe the actions you felt went well in this scenario. ● I feel I was a bit slow, but I got everything I needed to get for the delivery, I made sure the patient stayed calm, and made sure all her vital signs were stable. Scenario Analysis Questions[*] EBP/I Discuss why shoulder dystocia is an obstetrical emergency. ● It’s an obstetrical emergency because Physicians may cause injuries such as brachial plexus palsy, broken bones, and facial injuries. Depending on if an injury occurs after shoulder dystocia, the symptoms may include: Nerve damage and pain in the injured area; A claw-like hand appearance; Light paralysis of the affected limb. Mothers are also at risk for medical complications if shoulder dystocia occurs, such as hemorrhaging, uterine rupture, and lacerations. EBP Name one of the two distinct signs that indicate shoulder dystocia is present. ● One distinct signs of shoulder dystocia is the “turtle sign”, which involves the appearance and retraction of the fetal head (analogous to a turtle withdrawing into its shell), and another sign is the erythematous (red), puffy face indicative of facial flushing. This occurs when the baby's shoulder is obstructed by the maternal pelvis. EBP List potential problems for Amelia Sung and her baby related to the shoulder dystocia. ● She is already prone for it because she has a history of it. So, the potential problems are: It could happen again, and if it does the baby can have nerve damage and pain in the injured area; A claw-like hand appearance; Light paralysis of the affected limb. PCC/T&C What preventive measures were put in place related to Amelia Sung’s history of a previous shoulder dystocia? ● The NICU team was ready for the baby, the nurse and OB dr., were ready and there for This study source was downloaded by from CourseH on :42:06 GMT -05:00 the mother and baby for the whole delivery time. S/QI/I Consider what points might be included in a safety checklist for shoulder dystocia. ● The unit can use an established approach to managing and documenting episodes of shoulder dystocia. This approach can include— The Care provider clearly stating the concern for shoulder dystocia; Communication to others for assistance to put plan for safe delivery into place; Role designation of staff (e.g. recorder, patient/family communicator); Clinical maneuvers and directed maternal pushing; Recording time of dystocia identification, and time of maneuvers as performed; and documentation of episodes and elements. Concluding Questions Reflecting on Amelia Sung’s case, were there any actions you would do differently? Explain. ● I think I did well in this first maternity scenario. If I had more experience, I could probably notice things that I could have done better, but for my first time, I believe I did great. Describe how you would apply the knowledge and skills that you obtained in Amelia Sung’s case to an actual patient care situation. ● I would apply everything I did in this scenario in real life if the case was exactly or very similar.