Discuss how nursing services can contribute to the Healthcare Transformation Program, including the New Model of Care and Business Model.

How can a teacher/nurse educator make a huge impact on the lives of their clients/patients?

2. What do you think are the most important role of a nurse educator? Do you think they could effect change? What aspect of change would they create? identify and discuss your answers.

A 29-year-old woman, G1P1, was referred to a private hospital because of vaginal bleeding after cervical cerclage. She had previously delivered vaginally her first female infant (3,536 g) after cervical cerclage under the diagnosis of cervical incompetency. In the pregnancy discussed here, cervical cerclage was performed at 15 weeks gestation for the prevention of preterm delivery. Ultrasonography at that time demonstrated no abnormal findings. Twelve days after surgery sudden vaginal bleeding occurred. On admission in the 17th week of gestation, slight bleeding from the external cervical os was noted, and ultrasonography in our hospital demonstrated placenta previa. The placenta overlapped the internal cervical os and the distance from the lower placental edge to the internal os was 28 mm (2.8cm). Despite the administration of oral ritodrine hydrochloride, a β-adrenergic stimulant, bleeding continued in the amount of approximately 800 ml per day. The position of the placenta did not change. After appropriate counseling, the patient chose to terminate the pregnancy because she did not want to undergo the risk of life-threatening bleeding. Cervical os was still closed, and emergency cesarean section was performed at 18 weeksí gestation, 6 days after admission. OB-Gynecologist opened the abdomen with a vertical midline incision. A transverse incision of the lower uterine segment was made, and an infant weighing 175 g was delivered. The placenta covered the internal cervical os and was ablated easily. A double-layer closure was performed as usual. The operative bleeding, including amniotic fluid, was 900 ml, but bleeding continued after surgery. The hemoglobin value was decreased from 8.3 g/dl to 5.6 g/dl, and 5 units of banked concentrated red blood cells were transfused with prophylactic administration of gabexate mesilate for disseminated intravascular coagulation. After blood transfusion, bleeding decreased gradually. The patient was discharged in good condition 12 days after surgery. Two years later, she had a normal pregnancy, with the placental position being normal, and delivered by cesarean section a male infant weighing 3,010 g. No uterine abnormalities were evident during the surgery.
Questions;

1. Based on the case above, discuss the risk factors and signs and symptoms of placenta previa that are presents in the patient.

2.Is cervical cerclage done with the patients was the predisposing factor of placenta previa? Why? Why not?

3.Discuss and enumerate the nursing management of a patient having massive blood loss and undergoing blood transfusion due to placenta previa.

Share an example of when you experienced a client who valued health behaviors.

• Describe the assignment of value to health behaviors.
• What differentiates the value of health behaviors?
• Describe what contributes to barriers of health behaviors.
• Explain how the nurse assesses the value of health behaviors.

QI Essentials Toolkit: Cause and Effect Diagram A common challenge for improvement teams is determining what changes they can test to improve a process. A cause and effect diagram is an organizational tool that helps teams explore and display the many causes contributing to a certain effect or outcome. It graphically displays the relationship of the causes to the effect and to each other, helping teams identify areas for improvement. The cause and effect diagram is also known as an Ishikawa diagram, for its creator, or a fishbone diagram, for its resemblance to the bones of a fish. Teams list and group causes under the categories of Materials, Methods, Equipment, Environment, and People. IHI’s QI Essentials Toolkit includes the tools and templates you need to launch and manage a successful improvement project. Each of the nine tools in the toolkit includes a short description, instructions, an example, and a blank template. NOTE: Before filling out the template, first save the file on your computer. Then open and use that version of the tool. Otherwise, your changes will not be saved. Cause and Effect Flowchart Project Planning Form Diagram Histogram Run Chart & Control Chart Driver Diagram Pareto Chart Scatter Diagram Failure Modes and Effects PDSA Worksheet Analysis (FME