CUES Nahadlok aku kay tigda la ak gin dinugo as verbalized by the patient. Objective: Restlessness. Increased tension.

Feelings of helplessness V/S taken as follows: T: 37.2 P: 90 R: 18 Bp: 110/80

Nursing diagnosis Fear related to change in health status.

Rationale Dysfunctional uterine bleeding is abnormal uterine bleeding in the absence of clinical or ultrasonographic evidence of structural abnormalities, inflammation, or pregnancy. Treatment is usually with oral contraceptives. Dysfunctional uterine bleeding (DUB), the most common cause of abnormal uterine bleeding, occurs most often in women > 45 (> 50% of cases) and in adolescents (20% of cases). The cause is usually estrogen

Objectives After 4 hrs. Of nursing interventions, the patient will report fear and anxiety are reduced to a manageable level.

Intervention Independent: Identify patients perception of threat represented by the situation. Encourage patient to acknowledge and express fears. Provide opportunity for discussion of personal feelings or concerns and future expectations. Identify previous coping strengths of the patient and current areas of control or ability

Rationale Defines scope of individual problem, separate from physiological causes, and influences choice of intervention. Provides opportunity for dealing with concerns, clarifies reality of fears, and reduces anxiety to manageable level. Family members have individual responses to what is happening, and their anxiety may be communicated to patient, intensifying this emotion. Focuses attention on own capabilities, increasing sense of control.

Evaluation

production unopposed by progesterone, which can lead to endometrial hyperplasia. The endometrium sloughs and bleeds incompletely, irregularly, and sometimes profusely or for a long time. Endometrial hyperplasia, particularly atypical adenomatous hyperplasia, predisposes to endometrial cancer.

Encourage use of relaxation technique like deep breathing, guided imagery.

Provides active management of situation to reduce feelings of helplessness.

Cues Subjective: Haros 2 n ak k adlaw nanganak pero nagdidinugo p man aku as verbalized by patient. Objective: Restlessness Confusion. Irritability. V/S taken as follows: T: 36.8 P: 105 R: 24 Bp: 100/70

Nursing Diagnosis Risk for ineffective tissue perfusion related to hemorrhage

Rationale Postpartum hemorrhage is defined as a loss of blood in the postpartum period of more than 500 mL. The average, spontaneous vaginal birth will typically have a 500 mL blood loss. In cesarean births the average blood loss rises to 800-1000 mL. There is a greater risk of hemorrhage in the first 24 hours after the birth, called primary postpartum hemorrhage. A secondary hemorrhage occurs after the first 24 hours of birth. In the majority of cases the cause of hemorrhage is uterine atony, meaning that the uterus is not contracting enough to control the bleeding at the placental site. Other reasons for a hemorrhage would include retained placental fragments (possibly including a placenta accreta),

Objectives After 8 hours of nursing interventions , the patient will demonstrate adequate perfusion and stable vital signs.

Intervention Independent: Monitor amount of bleeding by weighing all pads. Frequently monitor vital signs. Massage the uterus. Place the mother in Trendelenberg position. Provide comfort measure like back rubs, deep breathing. Instruct in relaxation or visualization exercises. Provide diversional activities. Collaborative: Administer oxygen as indicated.

Rationale To measure the amount of blood loss. Early recognition of possible adverse effects allows for prompt intervention. To help expel clots of blood and it is also used to check the tone of the uterus and ensure that it is clamping down to prevent excessive bleeding. Encourages venous return to facilitate circulation, and prevent further bleeding. Promotes relaxation and may enhance patients coping abilities by refocusing attention. To supply adequate oxygen to the fetus and mother and prevents further complication.

Evaluation

trauma of some form, like a cervical laceration, uterine inversion or even uterine rupture, and clotting disorders

Administer medication as indicated (e.g Pitocin, Methergin)

To promote contraction and prevents further bleeding.

Cues Subjective: Bagat sumakit man nak tiyan na bagat manganganak n ako as verbalized by patient. Objective: Continued uterine contraction. Facial mask of pain. Irritability. V/S taken as follows: T: 37.3 P: 84 R: 19 Bp: 100/80

Nursing Diagnosis Activity intolerance related to muscle or cellular hypersensitivity

Rationale

Objectives After 8 hours of nursing interventions , the patient will use identified techniques to enhance activity intolerance.

Preterm labor is defined as uterine contractio ns occurring after 20 weeks of gestation and before 37 completed weeks of gestation. Risk factors include multiple geatation, history of previous preterm labor of delivery, abdominal surgery during current pregnancy , uterine anomaly, history of cone biopsy, maternal age younger

Interventions Independent: Assess status of the client and fetus. Encourage bed rest with patient in side lying position. Apply external uterine and fetal monitoring. Monitor patients vital signs closely, every 15 minutes. Instruct patient to report any feelings of difficulty of breathing or chest pain, dizziness, nervousness and irregular heart beats. Monitor uterine contractions, including frequency and domain. Collaborative: Obtain diagnostic studies including complete blood count, hemoglobin and hematocrit, urine,

Rationale Assessment provides a baseline date for future comparisons. Bed rest relieves pressure of the fetus on the cervix. Uterine and fetal monitoring provides evidence of maternal and fetal well being. Maternal pulse over 120 beats per minute or persistent tachycardia or tachypnea, chest pain, dyspnea and adventitious breath sounds may indicate impending pulmonary edema. Early recognition of possible adverse effects allows for prompt Monitor of uterine contractions

Evaluation

than 20 or older than age 35.

vaginal ang cervical cultures as ordered.

provides evidence of effective therapy. Urine, vaginal, and cervical cultures help to rule out infection as a causative factor for preterm labor. intervention.