Patient: (Maternal Focus) Is a 32-year-old gravida 4 para 3 ab 1 white female with no significant medical history. Yesterday she experienced a precipitous delivery of a 9 lb. 10 oz boy and suffered a third-degree vaginal tear. Focus on assessments and providing basic newborn care information to mom.
Medications: Phytonadione (Vitamin K1) Injectio, Erythromycin Ophthalmic Ointment – (Romycin Ophthalmic Ointment), itch Hazel Topical Solution – (Tucks Pads), Hydrocortisone Rectal Cream -(Anusol HC, Proctocream HC, Proctosol-HC)
-Discuss the nursing care priorities, assessments, and interventions for a patient
o Describe how to perform a postpartum assessment.
o Identify the causes of postpartum hemorrhage.
o Describe the nursing interventions used to treat postpartum hemorrhage. Non-pharmacological and pharmacological
o Explain the role of the nurse in supporting a postpartum patient with an unsupportive partner
Sample solution
Dante Alighieri played a critical role in the literature world through his poem Divine Comedy that was written in the 14th century. The poem contains Inferno, Purgatorio, and Paradiso. The Inferno is a description of the nine circles of torment that are found on the earth. It depicts the realms of the people that have gone against the spiritual values and who, instead, have chosen bestial appetite, violence, or fraud and malice. The nine circles of hell are limbo, lust, gluttony, greed and wrath. Others are heresy, violence, fraud, and treachery. The purpose of this paper is to examine the Dante’s Inferno in the perspective of its portrayal of God’s image and the justification of hell.
In this epic poem, God is portrayed as a super being guilty of multiple weaknesses including being egotistic, unjust, and hypocritical. Dante, in this poem, depicts God as being more human than divine by challenging God’s omnipotence. Additionally, the manner in which Dante describes Hell is in full contradiction to the morals of God as written in the Bible. When god arranges Hell to flatter Himself, He commits egotism, a sin that is common among human beings (Cheney, 2016). The weakness is depicted in Limbo and on the Gate of Hell where, for instance, God sends those who do not worship Him to Hell. This implies that failure to worship Him is a sin.
God is also depicted as lacking justice in His actions thus removing the godly image. The injustice is portrayed by the manner in which the sodomites and opportunists are treated. The opportunists are subjected to banner chasing in their lives after death followed by being stung by insects and maggots. They are known to having done neither good nor bad during their lifetimes and, therefore, justice could have demanded that they be granted a neutral punishment having lived a neutral life. The sodomites are also punished unfairly by God when Brunetto Lattini is condemned to hell despite being a good leader (Babor, T. F., McGovern, T., & Robaina, K. (2017). While he commited sodomy, God chooses to ignore all the other good deeds that Brunetto did.
Finally, God is also portrayed as being hypocritical in His actions, a sin that further diminishes His godliness and makes Him more human. A case in point is when God condemns the sin of egotism and goes ahead to commit it repeatedly. Proverbs 29:23 states that “arrogance will bring your downfall, but if you are humble, you will be respected.” When Slattery condemns Dante’s human state as being weak, doubtful, and limited, he is proving God’s hypocrisy because He is also human (Verdicchio, 2015). The actions of God in Hell as portrayed by Dante are inconsistent with the Biblical literature. Both Dante and God are prone to making mistakes, something common among human beings thus making God more human.
To wrap it up, Dante portrays God is more human since He commits the same sins that humans commit: egotism, hypocrisy, and injustice. Hell is justified as being a destination for victims of the mistakes committed by God. The Hell is presented as being a totally different place as compared to what is written about it in the Bible. As a result, reading through the text gives an image of God who is prone to the very mistakes common to humans thus ripping Him off His lofty status of divine and, instead, making Him a mere human. Whether or not Dante did it intentionally is subject to debate but one thing is clear in the poem: the misconstrued notion of God is revealed to future generations.
References
Babor, T. F., McGovern, T., & Robaina, K. (2017). Dante’s inferno: Seven deadly sins in scientific publishing and how to avoid them. Addiction Science: A Guide for the Perplexed, 267.
Cheney, L. D. G. (2016). Illustrations for Dante’s Inferno: A Comparative Study of Sandro Botticelli, Giovanni Stradano, and Federico Zuccaro. Cultural and Religious Studies, 4(8), 487.
Verdicchio, M. (2015). Irony and Desire in Dante’s” Inferno” 27. Italica, 285-297.
Sample Answer
Sample Answer
Nursing Care Priorities for a Postpartum Patient
Introduction
The postpartum period is a critical time for mothers as they transition from pregnancy to motherhood. For a 32-year-old woman who has experienced a precipitous delivery and suffered a third-degree vaginal tear, nursing care becomes essential to ensure her recovery and the health of her newborn. This essay discusses the nursing care priorities, assessments, and interventions for this patient, with an emphasis on postpartum assessment, causes of postpartum hemorrhage, treatment interventions, and the nurse’s role in supporting mothers with unsupportive partners.
Nursing Care Priorities and Assessments
Postpartum Assessment
A comprehensive postpartum assessment should be performed within the first hour after delivery and then regularly thereafter. Key components include:
1. Vital Signs: Monitor blood pressure, heart rate, temperature, and respiratory rate to detect any deviations from normal.
2. Uterine Tone: Assess the firmness of the uterus by palpating the fundus. A firm fundus indicates good uterine tone, while a boggy fundus suggests uterine atony, which can lead to hemorrhage.
3. Lochia Assessment: Evaluate the color, amount, and odor of vaginal discharge (lochia). Lochia rubra occurs in the first 1-3 days and is bright red; lochia serosa occurs from days 4-10 and is pinkish-brown; lochia alba follows and is yellowish-white.
4. Perineal Assessment: Inspect the perineum for swelling, bruising, and lacerations. For third-degree tears, assess pain levels and provide appropriate wound care.
5. Pain Assessment: Use a pain scale to evaluate the mother’s discomfort, particularly related to perineal trauma or uterine involution.
6. Breast Assessment: Evaluate breast engorgement and tenderness, as well as support breastfeeding if applicable.
7. Psychosocial Assessment: Assess emotional well-being and support systems, particularly in cases where the partner’s support may be lacking.
Causes of Postpartum Hemorrhage
Postpartum hemorrhage (PPH) is defined as blood loss greater than 500 mL after vaginal delivery or more than 1000 mL after cesarean delivery. Common causes include:
1. Uterine Atony: The most frequent cause of PPH, occurs when the uterus fails to contract effectively after delivery.
2. Trauma: Lacerations or tears in the vagina or cervix can contribute to excessive bleeding.
3. Retained Placenta: Retained placental fragments can prevent uterine contraction and lead to hemorrhage.
4. Coagulation Disorders: Any underlying conditions that affect blood clotting can exacerbate bleeding.
Nursing Interventions for Postpartum Hemorrhage
Non-Pharmacological Interventions
1. Uterine Massage: If uterine atony is suspected, gentle massage of the fundus can stimulate uterine contractions.
2. Positioning: Encourage the mother to lie flat or in a side-lying position with her legs elevated to promote venous return.
3. Fluid Resuscitation: Initiate IV fluids if indicated to maintain blood volume.
Pharmacological Interventions
1. Oxytocin (Pitocin): Administered intravenously or intramuscularly to promote uterine contractions.
2. Methylergometrine (Methergine): May be used if oxytocin is ineffective but should be avoided in patients with hypertension.
3. Tranexamic Acid (TXA): An antifibrinolytic agent that can reduce bleeding by promoting clot formation.
Supporting a Postpartum Patient with an Unsupportive Partner
The nurse plays a crucial role in supporting postpartum patients dealing with unsupportive partners. This support can involve:
1. Active Listening: Allowing the mother to express her feelings and concerns without judgment fosters a therapeutic environment.
2. Providing Education: Offering information about normal postpartum recovery, infant care, and available resources helps empower the mother.
3. Encouraging Support Networks: Suggesting that she reach out to family members, friends, or support groups can help mitigate feelings of isolation.
4. Assessing Mental Health: Regularly screening for signs of postpartum depression or anxiety and providing referrals to mental health resources if needed.
5. Advocating for Her Needs: Ensuring that her preferences and concerns are communicated to other healthcare providers fosters a sense of autonomy in her care.
Conclusion
In summary, nursing care priorities for a postpartum patient involve thorough assessments and timely interventions to manage complications such as postpartum hemorrhage while also providing emotional support. Nurses must remain vigilant in monitoring both physical recovery and psychosocial well-being, ensuring that mothers receive the comprehensive care they need during this pivotal time in their lives. By focusing on these critical areas, nurses can significantly impact maternal and newborn health outcomes.
