NURS 661 Week 8 Discussion 1: Advocating for Patient Care Essay

NURS 661 Week 8 Discussion 1: Advocating for Patient Care Essay

Discussion 1: Advocating for Patient Care

            Preterm labor as described in the video occurs when the mother’s body starts the fetus delivery process before the 37^th week of gestation. Normal labor is supposed to occur two weeks before or after the expected delivery date, between 38 weeks to 42 weeks. When the mother starts labor between the 20^th and 37^th week of gestation, it is considered preterm labor. It is highly associated with premature births and increased morbidity to breathing problems and learning difficulties among other physical complications to the premature baby(Garfield& Chin, 2020). As a new practicing nurse practitioner, it is necessary to conduct a comprehensive assessment of the mother’s pregnancy and develop the most effective care plan to prevent the complications associated with preterm labor.

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The assessment process entails complete patient history focusing on signs and symptoms suggesting preterm labor such as backaches, cramping, light to heavy vaginal bleeding, rupture or tear of the amniotic sac, and contractions which occur at intervals of less than 10 minutes, in addition to flu-like symptoms such as diarrhea, and nausea and vomiting (Griggs et al., 2020). Consequently, the patient history taking should also focus on possible risk factors such as the shortened cervix, multiple pregnancies, history of premature births, polyhydramnios, fetal birth defects, use of illicit drugs, age of the mother, and infections among others. Despite the diagnosis being made based on the patient presenting signs and symptoms, certain lab procedures must be ordered to confirm the primary diagnosis. Such assessments include pelvic examination, ultrasound, uterine monitoring, and lab tests such as vaginal swabs and urinalysis to confirm the presence of infection. the test results for patients with preterm labor will display immature pulmonary development of the fetus and cervical dilation of less than 4cm, in addition to the absence of factors that contraindicate continuity of the pregnancy (Taghinejad et al., 2021).

The patient treatment plan will mainly involve suppression of the preterm labor. The nurse must thus monitor closely for signs of increased risk of fetal injury and signs of maternal anxiety. Clinical guidelines recommend the surgical procedure and medication such as corticosteroid, magnesium sulfate, and tocolytics as treatment options providing a temporary solution (Patel & Ludmir, 2019). Corticosteroids help with fetal lung development, magnesium sulfate helps reduce the risks of cerebral palsy whereas tocolytics help in slowing down contractions.

However, the nursing care plan to minimize the risks of fatal injury will involve assessment of the mother’s condition which can lead to steroid contraindication for maturation of fetal lungs, administration of the prescribed medication appropriately, and monitoring the heart rate of the fetus for cervical changes (Cetinkaya& Kusdemir, 2018). It is also necessary to assess the anxiety level of the mother, and associated triggers by asking open-ended questions. It is also necessary to consider preventive measures for the management of preterm labor and inform the mother and her spouse of the need for follow-up care. The mother must be educated regarding the signs of hypoglycemia and sepsis and provided with emergency contact information in case they occur.

References

Cetinkaya, S., & Kusdemir, S. (2018). A premature baby’s nursing care plan. Open Journal of Obstetrics and Gynecology, 8(05), 437. https://doi.org/10.4236/ojog.2018.85050

Garfield, L., & Chin, E. (2020). Pharmacology for preterm labor. The Journal of Perinatal & Neonatal Nursing, 34(2), 155-161. https://doi.org/10.1097/JPN.0000000000000474

Griggs, K. M., Hrelic, D. A., Williams, N., McEwen-Campbell, M., & Cypher, R. (2020). Preterm labor and birth: a clinical review. MCN: The American Journal of Maternal/Child Nursing, 45(6), 328-337. https://doi.org/10.1097/NMC.0000000000000656

Patel, S. S., & Ludmir, J. (2019). Drugs for the treatment and prevention of preterm labor. Clinics in perinatology, 46(2), 159-172. https://doi.org/10.1016/j.clp.2019.02.001

Taghinejad, F., Nikfarid, L., Monfared, M. N., Hoseini, N., & Habibi, S. (2021). Nursing diagnoses of preterm infants in the neonatal intensive care unit: A cross-sectional study. Journal of Neonatal Nursing, 27(6), 451-458. https://doi.org/10.1016/j.jnn.2021.06.007

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Week 8 Discussion 1: Advocating for Patient Care

Value: 100 points

Due: Initial post by Day 3; replies to peers Day 7.

Grading Category: Discussions

Note: In this type of discussion, you will not see the responses of your classmates until after you have posted your own response to the question below.

As a new practicing nurse practitioner, there will be occasions in practice when your collaborating physician may not practice evidence-based care. Review this video from your collaborating physician.
Advocating for Patient Care (0:32 minutes)

Initial Post

Create and post a 3–5-minute video response to this physician and advocate for a different plan of care for your patient. Prepare your video as if you were actually speaking to the physician, including using professional language and professional attire.

In your video be sure to include your specific plan of care (testing, medications, and so on). If you agree with the physician regarding bedrest, give supporting evidence. If not, then support your plan.

In your post, in addition to the video, attach a Word document that outlines your plan of care for that patient and includes a list of APA-formatted references to support your plan of care for your patient. Post your video and reference list no later than Day 3.
Replies

Respond to one peer post and offer both commendation and constructive feedback on their video.

Please refer to the Grading Rubric for details on how this activity will be graded. The described expectations meet the passing level of 80%. Students are directed to review the Discussion Grading Rubric for criteria which exceed expectations.
Posting to the Discussion Forum

Select the appropriate Thread.
Select Reply.
Create your post.
Select Post to Forum.

This is a question and answer forum. In order to see other responses to these questions, you must first post your answer

Discussion Question Rubric

Note: Scholarly resources are defined as evidence-based practice, peer-reviewed journals; textbook (do not rely solely on your textbook as a reference); and National Standard Guidelines. Review assignment instructions, as this will provide any additional requirements that are not specifically listed on the rubric.

Note: The value of each of the criterion on this rubric represents a point range. (example: 17-0 points)
Discussion Question Rubric – 100 Points Criteria Exemplary
Exceeds Expectations Advanced
Meets Expectations Intermediate
Needs Improvement Novice
Inadequate Total Points
Quality of Initial Post Provides clear examples supported by course content and references.

Cites three or more references, using at least one new scholarly resource that was not provided in the course materials.

All instruction requirements noted.

40 points Components are accurate and thoroughly represented, with explanations and application of knowledge to include evidence-based practice, ethics, theory, and/or role. Synthesizes course content using course materials and scholarly resources to support importantpoints.

Meets all requirements within the discussion instructions.

Cites two references.

35 points Components are accurate and mostly represented primarily with definitions and summarization. Ideas may be overstated, with minimal contribution to the subject matter. Minimal application to evidence-based practice, theory, or role development. Synthesis of course content is present but missing depth and/or development.

Is missing one component/requirement of the discussion instructions.

Cites one reference, or references do not clearly support content.

Most instruction requirements are noted.

31 points Absent application to evidence-based practice, theory, or role development. Synthesis of course content is superficial.

Demonstrates incomplete understanding of content and/or inadequate preparation.

No references cited.

Missing several instruction requirements.

Submits post late.

27 points 40
Peer Response Post Offers both supportive and alternative viewpoints to the discussion, using two or more scholarly references per peer post. Post provides additional value to the conversation.

All instruction requirements noted.

40 points Evidence of further synthesis of course content. Provides clarification and new information or insight related to the content of the peer’s post.

Response is supported by course content and a minimum of one scholarly reference per each peer post.

All instruction requirements noted.

35 points Lacks clarification or new information. Scholarly reference supports the content in the peer post without adding new information or insight.

Missing reference from one peer post.

Partially followed instructions regarding number of reply posts.

Most instruction requirements are noted.

31 points Post is primarily a summation of peer’s post without further synthesis of course content.

Demonstrates incomplete understanding of content and/or inadequate preparation.

Did not follow instructions regarding number of reply posts.

Missing reference from peer posts.

Missing several instruction requirements.

Submits post late.

27 points 40
Frequency of Distribution Initial post and peer post(s) made on multiple separate days.

All instruction requirements noted.

10 points Initial post and peer post(s) made on multiple separate days.

8 points Minimum of two post options (initial and/or peer) made on separate days.

7 points All posts made on same day.

Submission demonstrates inadequate preparation.

No post submitted.

6 points 10
Organization Well-organized content with a clear and complex purpose statement and content argument. Writing is concise with a logical flow of ideas.

5 points Organized content with an informative purpose statement, supportive content, and summary statement. Argument content is developed with minimal issues in content flow.

4 points Poor organization and flow of ideas distract from content. Narrative is difficult to follow and frequently causes reader to reread work.

Purpose statement is noted.

3 points Illogical flow of ideas. Prose rambles. Purpose statement is unclear or missing.

Demonstrates incomplete understanding of content and/or inadequate preparation.

No purpose statement.

Submits assignment late.

2 points 5
APA, Grammar, and Spelling Correct APA formatting with no errors.

The writer correctly identifies reading audience, as demonstrated by appropriate language (avoids jargon and simplifies complex concepts appropriately).

Writing is concise, in active voice, and avoids awkward transitions and overuse of conjunctions.

There are no spelling, punctuation, or word-usage errors.

5 points Correct and consistent APA formatting of references and cites all references used. No more than two unique APA errors.

The writer demonstrates correct usage of formal English language in sentence construction. Variation in sentence structure and word usage promotes readability.

There are minimal to no grammar, punctuation, or word-usage errors.

4 points Three to four unique APA formatting errors.

The writer occasionally uses awkward sentence construction or overuses/inappropriately uses complex sentence structure. Problems with word usage (evidence of incorrect use of thesaurus) and punctuation persist, often causing some difficulties with grammar. Some words, transitional phrases, and conjunctions are overused.

Multiple grammar, punctuation, or word usage errors.

3 points Five or more unique formatting errors or no attempt to format in APA.

The writer demonstrates limited understanding of formal written language use; writing is colloquial (conforms to spoken language).

The writer struggles with limited vocabulary and has difficulty conveying meaning such that only the broadest, most general messages are presented.

Grammar and punctuation are consistently incorrect. Spelling errors are numerous.

Submits assignment late.

2 points 5
Total Points 100