Patient Y Exercise

Once Patient Y was placed in a labor room, treatment began immediately. As mentioned previously, the fetal heart rate decreased rapidly. During this time the nurse and physician performed several treatments in order to try and raise the fetal heart rate. First, the nurse applied 10L of oxygen via nasal cannula to the patient. Then, the nurse opened the Lactated Ringers wide so that they would enter the patient faster. Finally, the nurse changed the patient’s position from left sided to right sided and then to on all fours. These interventions did not improve the fetal heart rate. In order for the physician to determine that the fetal heart rate reading was completely accurate, he applied a fetal scalp electrode. The fetal heart rate reading
remained the same and this is when the physician called for an emergency cesarean section.
After transferring the patient to the operating room, the nurse immediately inserted an indwelling foley catheter. At the same time, the anesthesiologist administered general anesthesia to the patient. Once the patient was asleep, the anesthesiologist intubated the patient. Then the OBGYN performed the C-section and the newborn was delivered. At this time, the newborn was unstable and had no pulse. Immediately, the newborn received tactile stimulation, bulb suctioning and oxygen, which did not stimulate the newborn. Due to this, the neonatologist intubated the newborn. The heart rate began to rise slightly to the mid 60s, but the newborn was still unstable and was transported to the NICU. After being assessed by several neonatologists, the newborn was placed on a three-day brain cooling treatment plan. The cultural, psychosocial, socioeconomic, educational, and spiritual variables significantly impact the patient’s health status and the nursing care that is performed. Due to the fact that Patient Y had an emergency cesarean section shortly after arriving to the maternity unit, her initial admission assessment was not complete before her surgery. This means that these areas were not fully assessed prior to her delivery. After she recovered from the cesarean section, her admission assessment was completed. A patient’s culture plays a significant role in the birthing process.
Several areas are assessed including: nature and function of blood, diet and nutrition, family and social support, pain, and medicine and herbs. Prior to the cesarean section, Patient Y did consent to a blood transfusion if needed during or after the procedure. She also expressed to the nurse that she only wanted her husband to be in the delivery room because of her personal beliefs. After the cesarean section, Patient Y stated that she was on a regular diet with no food allergies. Patient Y’s family is extremely involved and supportive. After delivery, her children, husband, mother and father, and her siblings all came to the hospital to support her and the new baby. Patient Y consented to all medications and treatment that would provide her with optimal care. Patient Y’s psychosocial assessment was appropriate for her age and character. Patient Y had no history of any mental or emotional issues. She interacted and communicated with her family and healthcare members appropriately. She was pleasant and cooperative throughout her entire stay, despite her
situation. Patient Y’s socioeconomic status could be deduced from the information provided during her assessments. Patient Y received her prenatal care from the clinic, but she sees a private pediatrician for her children. Patient Y brought in a car seat with her and a diaper bag filled with supplies for her newborn. When asked if she would be using WIC, Patient Y stated would not be using WIC to access formula. After these assessments and observations I concluded that Patient Y would be considered middle class. During Patient Y’s admission assessment, her educational level was obtained. Patient Y stated “I graduated high school, but I did not further my education afterwards.” In regards to her occupation, this was not assessed and was not necessary for the healthcare team to safely treat her. Also, Patient Y had no spiritual variables that would have influenced her care. In order to provide appropriate nursing care while incorporating the variables mentioned above, “The nurse and other health care professionals should make adaptions to the nursing care plan based on the patient’s progress toward health (“Roy Adaptation Model,” 2016).” This is based off a model developed by Sister Callista Roy, which she called the “Roy Adaptation Model”.
Roy’s Adaption Model is “based on the belief that a human being is an adaptive system that continuously changes and interacts with environmental stimuli”(Mete & Sercekus, 2015). “The factors that influenced the development of the model included: family, education, religious background, mentors, and clinical experience (“Roy Adaptation Model,” 2016).” According to Roy’s model our environment is constantly changing and we must be able to adapt to these changes. This correlates perfectly with Patient Y. She planned on being induced and delivering her baby vaginal, but instead her environment changed and she was rushed to the operating room for an emergency cesarean section. The model also mentions “health and illness are inevitable dimensions of a person’s life (site).” For Patient Y, there was nothing she could have done differently to change the outcome of her delivery. Instead she needed to accept those changes and be willing and able to adapt to them in order to care for herself and her newborn. Not only did the patient need to adapt to these changes, so did the heath care professionals. Both Patient Y and
the healthcare team used Roy’s model and adapted well to the changes that need to take place.