Tina Nelson delivered a healthy male infant 6 hours ago. She had a midline episiotomy. This is her third pregnancy. She is now a G3P3003. She had an epidural block for her labor and delivery. She is now admitted to the postpartum unit.

1. What is important to note in the initial postpartum assessment? Include at least 5 assessments. Why is it important to assess for these things and what do the findings mean?

1. What are potential indications of a postpartum hemorrhage? List at least three indications.

1. What would you do if you found a boggy uterus?

1. What are the normal dose range and administration routes for oxytocin?

1. Induction/Stimulation of Labor:
2. Postpartum Hemorrhage:
3. Incomplete/Inevitable Abortion:

1. What are the contraindication, side effects, and adverse effects of oxytocin?

1. Complete the following dosage calculation:
   1. The physician has ordered 1000 mL Lactated Ringers (LR) with 10 units IV oxytocin. Begin at 1 mU/min and then increase by 1 mU/min every 30 minutes until regular contractions occur. Maximum dose is 20 mU/min.
      1. What is the beginning IV rate in mL/hr?
      2. What is the maximum IV rate in mL/hr?

1. What is the indication for Methergine, and what is a normal dose?
   1. What are contraindications for Methergine?
   2. What are the adverse reactions or possible side effects for Methergine?

1. What interventions would you anticipate in the event of a postpartum hemorrhage (independent and dependent nursing interventions)? List at least 5 interventions in order of priority.

Examine the role of spirituality in health care, from the perspective of both patients and health care providers. What impact do you see spirituality having on health care decisions and how does it potentially act as an impediment or benefit to the provision of nursing care, as you understand it?

Family Risk-Factor Perspective/systems

What are some of the differences in the Family Risk-Factor Perspective versus the Systems or Developmental Perspective

Which type of measurement tool can you use to collect data to demonstrate that your change project is worthwhile? Explain why you chose to use the specific measurement tool.

A 64-year old diabetic man reports he has numbness and burning sensations in his toes for the past 6 months.

For the case you have chosen, post to the discussion:

• Discuss what questions you would ask the patient, what physical exam elements you would include, and what further testing you would want to have performed.
• In SOAP format, list:
  • Pertinent positive and negative information
  • Differential diagnosis
  • working diagnosis
  • Treatment plan, including: pharmacotherapy with complementary and OTC therapy, diagnostics (labs and testing), health education and lifestyle changes, age-appropriate preventive care, and follow-up to this visit.
• Use at least one scholarly source other than your textbook to connect your response to national guidelines and evidence-based research in support of your ideas.