Care Plan 1: Labor Pain: As labor was progressing and the mother was pushing it was apparent she felt a small amount of discomfort, mostly while she was pushing. As the baby began it’s descent farther down the birth canal, the mother was feeling pressure and became more uncomfortable. She was grimacing between contractions.
Intervention 1: Providing the use of nonpharmacologic comfort measures, such as a cool, moist wash cloth, to bring some measure of relief to the mother during labor (Doenges, Moorhouse, & Murr, 2016, p. 616).
• Rationale: This nonpharmacologic measure should promote relaxation and comfort for the mother, especially during a time when she is not advised to request analgesia or anesthesia such as in labor (Doenges, Moorhouse, …show more content…
Care Plan 2: Risk for Fall: The goal for this mother is to remain free from a fall injury related to the epidural she was given. The epidural anesthetizes the mother’s lower extremities. She would have the feeling that her legs could not bear her weight and she would not be able to ambulate on her own.
Intervention 1: Evaluating the mother’s current condition that enhances her risk for falls (Doenges, Moorhouse, & Murr, 2016, p. 293).
• Rationale: Any short-term situation, such as a new medication, can affect the patient’s balance. The mother was given epidural almost 24 hours after she was admitted into the hospital and from then on her sense of balance was affected. At the time of transfer to the postpartum section, the nurse advised the mother to stand up slowly because she may feel that her legs feel week and wobbly. She was transferred in a wheelchair for this safety reason (Doenges, Moorhouse, & Murr, 2016, p. 293).
• Outcome: The mother will remain free from falls during the remainder of her 48-hour hospital stay.
Intervention 2: Encouraging use of assistive aids (Doenges, Moorhouse, & Murr, 2016, p.
Intervention 1: Providing the use of nonpharmacologic comfort measures, such as a cool, moist wash cloth, to bring some measure of relief to the mother during labor (Doenges, Moorhouse, & Murr, 2016, p. 616).
• Rationale: This nonpharmacologic measure should promote relaxation and comfort for the mother, especially during a time when she is not advised to request analgesia or anesthesia such as in labor (Doenges, Moorhouse, …show more content…
Care Plan 2: Risk for Fall: The goal for this mother is to remain free from a fall injury related to the epidural she was given. The epidural anesthetizes the mother’s lower extremities. She would have the feeling that her legs could not bear her weight and she would not be able to ambulate on her own.
Intervention 1: Evaluating the mother’s current condition that enhances her risk for falls (Doenges, Moorhouse, & Murr, 2016, p. 293).
• Rationale: Any short-term situation, such as a new medication, can affect the patient’s balance. The mother was given epidural almost 24 hours after she was admitted into the hospital and from then on her sense of balance was affected. At the time of transfer to the postpartum section, the nurse advised the mother to stand up slowly because she may feel that her legs feel week and wobbly. She was transferred in a wheelchair for this safety reason (Doenges, Moorhouse, & Murr, 2016, p. 293).
• Outcome: The mother will remain free from falls during the remainder of her 48-hour hospital stay.
Intervention 2: Encouraging use of assistive aids (Doenges, Moorhouse, & Murr, 2016, p.