1 How can you provide non-pharmacological comfort

1 How can you provide non-pharmacological comfort to this patient? One way the nurse can facilitate relaxation is by assisting the patient in finding a position of comfort. Breathing methods are also taught as attention-focusing and distraction techniques to help relieve discomfort and pain during labor. The patient should instruct to take slow, deep cleansing breaths through the nose and out through the mouth at the beginning of every contraction. As the labor progresses and the contractions increase in frequency and intensity, the patient may need to change to a modified-paced breathing pattern. Music can help to relaxing environment and boost spirits. During labor, music provides comfort and decreases maternal anxiety by stimulating the release of endorphins. Other non-pharmacological methods such as; relaxation help reduce anxiety level and stress, guided imagery, massage, touch, aromatherapy, cold and heat therapy, and acupuncture. What are the pharmacological methods to use? Medication is infused narcotic analgesics, which are directly injected through an IV. Sedatives are used during the early stage of labor, and that is because they relieve anxiety and induce sleep; this stage of labor rest is generally prescribed to the patient. Barbiturates are another pharmacological method used; secobarbital sodium is the most commonly used in labor. It is fast-acting and has a mild sedation effect after 15 minutes, and lasts for three to four hours. Benzodiazepines work similarly to barbiturates and help relieve pain and decrease nausea and vomiting when combined with an opioid analgesic. H1-receptor antagonists block histamines at receptor sites and produce sedative, anti-Parkinson, and antiemetic effects. Promethazine produces marked sedation with strong antiemetic effects and is often combined with opiates because it increases the impact. Hydroxyzine is usually used during early or prodromal labor, which helps to decrease nausea and anxiety. Without prenatal records or history GBS is unknown. What must you provide? A culture-based screening should be conducted according to CDC. It advises that if the intrapartum temperature is observed and membranes’ delight happens after 18 hours, the patient is provided with intrapartum antibiotics while in labor. Contractions 5 minutes apart, and you receive an order to augment labor – what non-pharmacological methods can you employ (or ask the M.D. to provide?) Some non-pharmacological that can be used to expedite contractions include requesting the patient to stand, walk, move aside or massage the nipples. If these methods fail, Pitocin, which is a pharmacological method, may be used. Pitocin is ordered; please include at what rate you will start Pitocin and how often you titrate. What equipment is needed to hang and run Pitocin IV? The Pitocin must be diluted and given intravenously, with titration being done every one hour such that it imitates normal labor. One 1-mL vial containing ten units of oxytocin to 1000 mL of 0.9% aqueous sodium chloride or Ringer’s lactate is added jointly. Infusion bottles are used. The low dose will start at two milli units per minute. It can increase two milli units per minute every 30 minutes until five contractions or less that last 45 to 90 seconds in 10 minutes and averaged over 30 minutes. The maximum dose is 20 milliunits per minute. The high amount will start at four milli units per minute. It can increase to 4 milli units per minute every 30 minutes until five contractions or less that last 45 to 90 seconds in 10 averaged over 30 minutes. The maximum dose is 20 milli units per minute. The equipment needed for Pitocin IV is piggyback solution is flagged with a medication label and connected to the intravenous infusion at the port nearest the point of venous insertion. Part 1 Ask the patient if she has a history of Group B Strep or has been done had Group B Strep test done. Also, ask a patient if she has a history of congestive heart failure, diabetes, heart disease. These diseases can increase the risk of GBS. Ask about other symptoms such as vaginal burning, irritation, and or unusual discharge. Nursing interventions would be routine prenatal screening and treatment for asymptomatic bacteriuria. A Progesterone supplementation, micronized progesterone vaginal gel, or suppositories every night starting at weeks 16 through 36 could reduce preterm labor. Fetal Fibronectin testing is done to help determine the risk of preterm labor. Fetal fibronectin is a glycoprotein produced by fetal membranes. When there are contractions, fetal fibronectin is released. This testing is usually conducted where there is no patient bleeding. Tocolytic medication could be used with a doctor’s order; it is used to inhibit uterine contractions and usually is effective for 48 hours. It is generally given to women whose fetuses would benefit from the delay in delivery. Antenatal corticosteroids are recommended for pregnant women between 24 and 34 weeks of gestation which may be at risk of preterm delivery within seven days. A tocolytic is administered intramuscularly as a 60-mg loading dose followed by 30 mg every 6 hours for 48 hours. As a tocolytic, sulindac is administered at a dose of 200 mg orally every 12 hours for 48 hours. Side effects of tocolytic are Tachycardia, hypotension, palpitations, shortness of breath, chest pain, pulmonary edema, hypokalemia, hyperglycemia. Contraindications include tachycardia-sensitive maternal cardiac conditions. Tocolytics decreased the risk of delivery within seven days. Tocolytics were not associated with improved perinatal outcomes. Maternal side effects of tocolytic were palpitations, nausea, tremor, chorioamnionitis, hyperglycemia, hypokalemia, and the need to discontinue treatment. Although tocolytics prolong pregnancy, they have not been shown to improve perinatal or neonatal outcomes and adversely affect women in preterm labor. 2 How can you provide non-pharmacological comfort to this patient? One way the nurse can facilitate relaxation is by assisting the patient in finding a position of comfort. Breathing methods are also taught as attention-focusing and distraction techniques to help relieve discomfort and pain during labor. The patient should instruct to take slow, deep cleansing breaths through the nose and out through the mouth at the beginning of every contraction. As the labor progresses and the contractions increase in frequency and intensity, the patient may need to change to a modified-paced breathing pattern. Music can help to relaxing environment and boost spirits. During labor, music provides comfort and decreases maternal anxiety by stimulating the release of endorphins. Other non-pharmacological methods such as; relaxation help reduce anxiety level and stress, guided imagery, massage, touch, aromatherapy, cold and heat therapy, and acupuncture. What are the pharmacological methods to use? Medication is infused narcotic analgesics, which are directly injected through an IV. Sedatives are used during the early stage of labor, and that is because they relieve anxiety and induce sleep; this stage of labor rest is generally prescribed to the patient. Barbiturates are another pharmacological method used; secobarbital sodium is the most commonly used in labor. It is fast-acting and has a mild sedation effect after 15 minutes, and lasts for three to four hours. Benzodiazepines work similarly to barbiturates and help relieve pain and decrease nausea and vomiting when combined with an opioid analgesic. H1-receptor antagonists block histamines at receptor sites and produce sedative, anti-Parkinson, and antiemetic effects. Promethazine produces marked sedation with strong antiemetic effects and is often combined with opiates because it increases the impact. Hydroxyzine is usually used during early or prodromal labor, which helps to decrease nausea and anxiety. Without prenatal records or history GBS is unknown. What must you provide? A culture-based screening should be conducted according to CDC. It advises that if the intrapartum temperature is observed and membranes’ delight happens after 18 hours, the patient is provided with intrapartum antibiotics while in labor. Contractions 5 minutes apart, and you receive an order to augment labor – what non-pharmacological methods can you employ (or ask the M.D. to provide?) Some non-pharmacological that can be used to expedite contractions include requesting the patient to stand, walk, move aside or massage the nipples. If these methods fail, Pitocin, which is a pharmacological method, may be used. Pitocin is ordered; please include at what rate you will start Pitocin and how often you titrate. What equipment is needed to hang and run Pitocin IV? The Pitocin must be diluted and given intravenously, with titration being done every one hour such that it imitates normal labor. One 1-mL vial containing ten units of oxytocin to 1000 mL of 0.9% aqueous sodium chloride or Ringer’s lactate is added jointly. Infusion bottles are used. The low dose will start at two milli units per minute. It can increase two milli units per minute every 30 minutes until five contractions or less that last 45 to 90 seconds in 10 minutes and averaged over 30 minutes. The maximum dose is 20 milliunits per minute. The high amount will start at four milli units per minute. It can increase to 4 milli units per minute every 30 minutes until five contractions or less that last 45 to 90 seconds in 10 averaged over 30 minutes. The maximum dose is 20 milli units per minute. The equipment needed for Pitocin IV is piggyback solution is flagged with a medication label and connected to the intravenous infusion at the port nearest the point of venous insertion. Part 1 Ask the patient if she has a history of Group B Strep or has been done had Group B Strep test done. Also, ask a patient if she has a history of congestive heart failure, diabetes, heart disease. These diseases can increase the risk of GBS. Ask about other symptoms such as vaginal burning, irritation, and or unusual discharge. Nursing interventions would be routine prenatal screening and treatment for asymptomatic bacteriuria. A Progesterone supplementation, micronized progesterone vaginal gel, or suppositories every night starting at weeks 16 through 36 could reduce preterm labor. Fetal Fibronectin testing is done to help determine the risk of preterm labor. Fetal fibronectin is a glycoprotein produced by fetal membranes. When there are contractions, fetal fibronectin is released. This testing is usually conducted where there is no patient bleeding. Tocolytic medication could be used with a doctor’s order; it is used to inhibit uterine contractions and usually is effective for 48 hours. It is generally given to women whose fetuses would benefit from the delay in delivery. Antenatal corticosteroids are recommended for pregnant women between 24 and 34 weeks of gestation which may be at risk of preterm delivery within seven days. A tocolytic is administered intramuscularly as a 60-mg loading dose followed by 30 mg every 6 hours for 48 hours. As a tocolytic, sulindac is administered at a dose of 200 mg orally every 12 hours for 48 hours. Side effects of tocolytic are Tachycardia, hypotension, palpitations, shortness of breath, chest pain, pulmonary edema, hypokalemia, hyperglycemia. Contraindications include tachycardia-sensitive maternal cardiac conditions. Tocolytics decreased the risk of delivery within seven days. Tocolytics were not associated with improved perinatal outcomes. Maternal side effects of tocolytic were palpitations, nausea, tremor, chorioamnionitis, hyperglycemia, hypokalemia, and the need to discontinue treatment. Although tocolytics prolong pregnancy, they have not been shown to improve perinatal or neonatal outcomes and adversely affect women in preterm labor. please comment /discuss on my above two post if you agree or disagree. Please explain and include references SCIENCE HEALTH SCIENCE NURSING NUR 2633

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