M. Child response posts - Nursing
M. Child Response Posts
· Explain why you agree or disagree with at least two other classmates’ responses
· Provide at least two examples and one credible resource to support each response
Jessica Pappas
3 hours ago, at 7:10 PM
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I believe that the Mississippi nurse acted appropriately when caring for her patient, and I would hope I would respond as she did. She immediately started monitoring the baby with a fetal heart monitor, a tocodynamometer and performed a vaginal exam (JOGNN, 2015). During the vaginal exam, the nurse noted no dilation (JOGNN, 2015). The nurse was directed to continue monitoring the mom’s glucose level for insulin administration. When the mother reported abdominal pain to the nurse, the nurse notified the doctor immediately. The nurse utilized her team around her to help continue monitoring for a fetal heartbeat which she couldn’t find, while the other nurse continued paging the doctor (RegisteredNursing.org, 2021). The nurse's notes in the patient’s chart were very thorough and concise. Everything was accurately described, and that makes it easy for someone coming in to understand exactly what transpired. Because her documentation was done so completely, I believe this is why she was not found negligent in her care of the patient (RegisteredNursing.org, 2021).
In Texas, I found that nurse did most things wrong from the start. We know how important it is to be monitoring the baby's heart rate and have fetal monitors hooked up, the nurse knew these were not working accurately for hours after admission. This should have been addressed immediately and whatever troubleshooting needed to be done-maybe finding new monitors etc. should have been a priority (JOGNN, 2015). If we do not know the babies’ stats, how can we care for them? How can we monitor contractions? The readings that were being delivered from the monitors should have been reported to the doctor ASAP- not notifying the doctor in itself is negligent. Lastly, this nurse continued giving the mother Pitocin which would have been contraindicated due to the non-reassuring fetal heart tracings (JOGNN, 2015). Pitocin is the synthetic form of oxytocin, the hormone responsible for inducing labor and strengthening uterine contractions. After noticing fetal distress, the nurse should have ceased Pitocin immediately. She truly failed to advocate for this patient (RegisteredNursing.org, 2021). One of her main responsibilities is notifying the doctor of any changes or issues and she even failed to do that.
References:
RegisteredNursing.org. (2021). Ethical Practice: NCLEX/RN. Retrieved on October 4, 2021, from
https://www.registerednursing.org/nclex/ethical-practice/
JOGNN. (2015). Recognition and Treatment of Intrapartal Fetal Distress. Retrieved on October 4, 2021, from,
https://www.jognn.org/article/S0090-0311(15)30373-2/fulltext#relatedArticles
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Precious Ikonagbon
5 hours ago, at 5:53 PM
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The nurses must be extreme and concentrated during childbirth because it is a life-saving procedure. If nurses and physicians do not take responsibility for their work and conduct it properly, several legal situations may arise. In the case of Texas, the nurses continued to adjust the Pitocin without ensuring that a fetal cardiac tracing was present. Unlike in Mississippi, the nurses checked for cardiac illustrations and verified that the Toc transducer was operational so that they could read heart tracings. The nurses in Texas acted negligently by failing to alert the physician that the heart monitor tracings were missing.
Electronic monitoring of fetal heart rate and uterine activity patterns is also necessary (Euliano et al., 2020). The nurse in Mississippi started fetal heart monitoring right away and performed a vaginal exam to check for vaginal dilation. On the other hand, the nurse in Texas neglected to monitor the fetal heart rate as required during amniotomy. Monitoring heart sound could have ensured that there were no occlusions that would have hampered fetal circulation.
A vaginal examination check is necessary to determine the capacity to accept the passage of a fetus head to achieve a normal birth (Gerevich, 2020). After the mother was taken to the hospital in Mississippi, the nurse performed a vaginal dilation check, which revealed no dilatation of the cervix. On the other hand, the nurse in Texas failed to evaluate vaginal dilation to determine the mother's potential to deliver normally, which could have guided care.
It is critical to establish fetal well-being during labor and delivery and get a baseline measurement of uterine activity and fetal heart rate. While the nurse in Mississippi began using a fetal heart monitor and a tocodynamometer, the nurse in Texas did not start using an electronic fetal monitor until a quarter-hour before the induction technique.
While the nurse in Mississippi assessed the intensity of the contractions and notified the doctor, the nurse in Texas failed to monitor the mother's reactions to the contractions' duration and intensity. The Texas nurse was unable to consult or alert the physician, resulting in a tragic maternal outcome.
Reference
Euliano, T. Y., Darmanjian, S., Nguyen, M. T., Busowski, J. D., Euliano, N., & Gregg, A. R. (2020). Monitoring fetal heart rate during labor: a comparison of three methods. Journal of pregnancy, 2017.
Gerevich, N. V. (2020). Ultrasound examination during delivery–is an additional tool for obstructive birth
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