For this discussion, a 32-year-old female patient will be discussed. She was admitted to the hospital at 39 weeks gestation based upon the determination made at her 18-week ultrasound. At the time of presentation, she was experiencing uterine contractions every four minutes with increasing intensity. The patient stated that her pain had began approximately one hour prior and the intensity of her contractions increased with the past half hour. The patient is known as Gravid 2, Para 1 and she had a prior pregnancy without any complications. After a vaginal examination, it was determined that the cervix is 90 percent effaced and she is dilated 8 cm. The patient experienced a normal labor and delivered a healthy boy with an 8 APGAR score at birth and 9 APGAR score after five minutes. During birth, she experienced a second-degree perineal laceration which was repaired with sutures. The patient was discharged two days after her delivery and did not experience any complications. Her first postpartum visit with the OBGYN was scheduled to determine if she had any concerns or issues to discuss regarding her health and the birth of her child. Although the child was born healthy and the delivery was relatively seamless.
Body
For this patient, psychosocial integrity was important because regardless of the nature of the birth, there is a common risk of developing postpartum depression which can negatively impact patient outcomes and cause significant harm to the patient and to the child if left untreated (Yim, Stapleton, Guardino, Hahn-Holbrook, & Schetter, 2015). Although there are no clear signs of postpartum depression, an examination of the patient’s psychosocial state is warranted during the first examination after birth; in addition, this examination should include psychological factors which impact many new mothers and how to determine if postpartum depression exist for the patient (Yim et al., 2015). For this patient, her psychosocial health is of critical importance and should be monitored for any symptoms of postpartum depression which could affect her health and impact her ability to bond with her child (Yim et al., 2015). If this is not addressed, the problem could be further exacerbated over time and cause additional harm for the patient with consequences that could potentially last for many years.
For this patient, comfort and rest were also very important because after birth, the patient should be made as comfortable as possible so that her body can begin to get back to a normal state and she can recover as anticipated. Without the appropriate amount of rest and the ability to bond with her child, there could be a risk of additional emotional and physical complications in the future. Therefore, prevention of these risk factors is of critical importance and can make a difference for the patient in her recovery. The follow up visit should include a discussion of how much rest the patient is obtaining on average and if she is experiencing any type of fatigue that is affecting her sleep patterns.
Analysis/Reflection
For this patient, interdisciplinary collaboration with the physician was critical and
demonstrated the importance of preserving the patient’s quality of life and psychosocial integrity as best as possible. During these interactions, discussions regarding the patient’s level of comfort and the circumstances after birth were conducted to better determine how to proceed with a plan of care that will have the desired impact on the patient as she continues her recovery.
In addressing the patient’s recovery related to psychosocial integrity, it was very
important to evaluate how the patient is responding to the child, if she and the child are bonding as expected, and if the patient has an emotional connection to her child. Regarding rest and comfort, communication between the nurse and other staff is critical to ensure that the patient has the proper amount of rest and her recovery is proceeding as expected.
For this patient, psychosocial integrity, rest, and comfort are critical to her wellbeing
after birth. Therefore, it is important to address these concerns in a clinical capacity and to provide the necessary treatments that will not only address her physical health but also her mental and psychological health. Birth is often a very difficult experience for many women even if they do not experience any complications. Therefore, all physical issues must be addressed and support the development of a framework to treat the patient’s needs in a comprehensive manner.
During nursing care, the patient’s family was taken into consideration, including her
husband who was in the room at the time of the birth. This was important to the mother and father because it allowed the father to have firsthand experience with the birth. During this period, the father asked several questions which were addressed such as healing and recovery times and what to expect in the first few days after birth so that the patient’s health was a critical priority.
For this patient, clinical staff members were responsible for ensuring her patient
safety and in demonstrating that the patient would recover in a timely manner without further complications. For instance, assisting the mother when she went to the bathroom was an important safety tool and preventing her from getting out of bed without assistance was another step forward. Finally, the patient’s sutures were monitored to prevent any possible risk of infection and to ensure that healing of the wound was occurring as planned.
