Nursing Skills Carried Out Whilst Working in Maternity:

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Nursing skills carried out whilst working in maternity:
• Ward admission for elective LSCS list eg, correct paperwork, consent, next of kin, care preferences where indicated, etc..
• Cannulation for access plus associated work up
• Liasing with medical staff, anaesthetics/ O and G
• Womans advocate
• Staying in PACU with new family, providing direct nursing care for immediate post operative half hour.

• Problem solving: initiating care interventions, with timely review and analysis, eg,
Problem: low post op BP in PACU with spinal anaesthetic in place
Care intervention: take manual BP, and reduce angle of head elevation
Review: BP same on manual, => 20% drop systolic. Anaesthetist informed.
Pt symptomatic now vomiting: maxalon IV as per PACU standing order
Review: BP same, IV fluids increased: pt healthy with no heart/cvs problems.
Anaesthetist orders 4mg odansetron IV antinauseant ( 5ht inhib action)
To reduce post op nausea and vomiting/due to hypotension? Sympathetic response to spinal.
Review BP taken and immediate effect of increased fluids ( volume) has improved BP. Nausea/vomiting settling from drug interventions.
Patient feels improved, colour returns to face.
Analysis: nursing interventions can help in an acute clinical situation. Although the anaesthetist was informed, several things had been initiated by me prior to him being notified:
A manual BP was taken to confirm what the autocuff was reading,
Head was lowered, and pillow under feet to improve the venous return
Fluids were speeded up to increase the circulating volume ( stroke volume X resistance= HR ) after confirming no obvious CVS problems.
This is important because increasing fluids and overloading a known weakened heart, could possibly lead to right cardiac failure or pulmonary hypertension. Increasing a patients IV drip rate without a medical order, can be reckless. I

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