[Expert Solution]: WEEK 1 Clinical Case Study Twenty-year-old…

WEEK 1 Clinical Case Study Twenty-year-old Juanita Gutierrez is a G1P1, Mexican migrant worker. She had a spontaneous vaginal delivery (SVD) 12 hours ago, following a labor of 18 hours. Pregnancy was complicated by gestational hypertension diagnosed 2 weeks ago at her first prenatal visit. Labor was induced at 38 weeks because of increased symptoms of gestational hypertension and subsequent pre-eclampsia. She still has 3+ pitting ankle edema. Her face and hands appear puffy, and she has deep tendon reflexes 2+. SHe is receiving IV Lasix. Her second dose of Lasix was given by the previous shift. Nurse Kellie is coming on duty and making rounds. Kellie notes that her urinary output has not significantly increased, having 100mL total since delivery. 1. What physical assessment findings presented are of concern to you, as Ms. Gutierrez’s nurse? 2. What facts regarding Ms. Gutierrez’s personal history are most concerning to you? 3. What would be 2 appropriate nursing diagnoses for Ms. Gutierrez? a. b. 4. What are the critical nursing interventions for Ms. Gutierrez? Consider what all will be included in your assessment, as well as subsequent interventions 5. Why is Ms. Gutierrez still experiencing edema and decreased urine output? 6. Use the chart below to outline maternal and fetal risks of pre-eclampsia? Maternal Risks Fetal Risks – – – – – – – – – – – – 7. Ms. Gutierrez has received Pitocin for labor induction, Magnesium Sulfate and Lasix. What is the action, usual dose and side effects of these medications? Medication Action Usual Dose Side Effects Pitocin Magnesium Sulfate Lasix 8. What are the signs of magnesium toxicity? 9. What is the antidote for magnesium sulfate? Kellie discovered that the last dose of Lasix hadn’t been given. She administers the Lasix before she leaves. Juanita’s urinary output is 800mL and her edema is decreasing. 10. Review the pathophysiology of preeclampsia and describe the signs & symptoms: Pathophysiology Clinical Signs Symptoms Ms. Gutierrez is ready for discharge and will be returning to her migrant farmworker’s community, which is now 200 miles north of this facility. 11. How can the nurses include the family in Juanita’s care? 12. Write a bulleted list of the essential elements to include in the patient’s discharge instructions for MS Gutierrez. 13. How might the nurses ensure that Ms. Gutierrez and her infant receive the necessary follow-up care after discharge? 14. What ways can you ensure Ms. Gutierrez receives all the necessary discharge education given that English is not her primary language?