E-learning modules for Integrated Virtual Learning


    perinatal nursing: day 1 online discussion

    Share

    ma. cristina arroyo

    Posts : 75
    Join date : 2009-06-24

    Re: perinatal nursing: day 1 online discussion

    Post  ma. cristina arroyo on Mon 10 Aug 2009, 11:19 pm

    i would like to post a question for ms. verain, health options such as? yes, i agree with the transpo as not modifiable factors but again, the problem arising is Lata needs to be given BT or needs to be transported to acquire the said management. i dont think one can offer health options at this point where it is already a matter of life and death.

    railibo-
    Guest

    Re: perinatal nursing: day 1 online discussion

    Post  railibo- on Mon 10 Aug 2009, 11:18 pm

    with regards to the husband, I guess he should have been more involved with his wife's pregnancy. I mean he doesn't have to wait for Lata to tell him what's going on about her pregnancy. He should have also shown his concern knowing that her pregnancy is a risky one.

    jenny c.
    Guest

    Re: perinatal nursing: day 1 online discussion

    Post  jenny c. on Mon 10 Aug 2009, 11:18 pm

    sorry for being rude, i guess it was her (lata) who is the cause why it really happened..

    1. She was already informed of her current condition- it was high risk and complex interventions are highly needed to make it a success, still she pursued on having a home delivery.

    2. Pregnancy should not become a burden to the family. If the pregnancy was planned and a lot of preparation for the pregnancy was done, like finances, they should have had enough time of saving money for the delivery and could eventually afford services needed for high risk pregnancy.

    arch_ang
    Guest

    Re: perinatal nursing: day 1 online discussion

    Post  arch_ang on Mon 10 Aug 2009, 11:17 pm

    i agree ara...=)

    ara_portillo

    Posts : 74
    Join date : 2009-06-24

    on lata's case..

    Post  ara_portillo on Mon 10 Aug 2009, 11:16 pm

    yes.. i agree with other's posts... i think with your answers we are already answering all the questions. but a striking point that i read with the posts is that the condition of Lata should be disclosed to her husband since this is supposedly the decision of the couple.. (like what tina said).. but Lata did not inform the husband about her case.. do you think the huband could have searched for some ways if only he is aware of the condition?

    Angel Ve
    Guest

    Case 2

    Post  Angel Ve on Mon 10 Aug 2009, 11:13 pm

    2. What should she have done differently?

    The health officer should have provided Lata with all of the factual information related to her case. She should have also explained to Lata the ramifications of not being able to deliver in a hospital with fully equipped medical services. I think in this case, there is a gap with the education that should have been provided. Since the inaccessibility to the hospital and transportation is not easily modifiable, the health officer should have provided Lata with the choices she has to consider regarding to her health.

    anlorrai
    Guest

    answer case 2

    Post  anlorrai on Mon 10 Aug 2009, 11:10 pm

    Yes I agree with Ms. Angel, Lata should have gone to the district hospital wherein her needs could have been met since she is considered as high risk for pregnancy. I think her husband should have insisted to her wife to give birth in the district hospital and he should have inquired for any organizations or institutions that could help them to pay for their expenses in the hospital. I noticed in this scenario, that lack of awareness regarding the condition of a high risk pregnancy like Latas condition can worsen her condition. I think the family, should have explore more about Latas condition by inquiring the health clinics, or district hospital. I think the Health officials should have warned Lata about her present condition and the possible consequences if she disregards her condition and follow up could have been made with this high risk pregnancy.

    ara_portillo

    Posts : 74
    Join date : 2009-06-24

    still on Lata\'s Case....

    Post  ara_portillo on Mon 10 Aug 2009, 11:09 pm

    as of now.. the reasons that you we have identified on Lata's case can fall on the following themes:
    -health status of Lata (on high risk pregnancy - small built, with co-occuring conditions like anemia and PIH)
    -poor decision making done on the management of her condition (in women's health, we have mentioned that most women will think of her family's needs over hers)
    -poverty
    -delays in the care given (reaching the hospital)
    -poor services in the health care facility (lack of blood and skilled health care providers)
    -poorly managed health condition of LAta leading to hypovolemic shock


    Last edited by ara_portillo on Mon 10 Aug 2009, 11:20 pm; edited 2 times in total

    ma. cristina arroyo

    Posts : 75
    Join date : 2009-06-24

    Re: perinatal nursing: day 1 online discussion

    Post  ma. cristina arroyo on Mon 10 Aug 2009, 11:09 pm

    What should have been done?

    At one point in our situation, there was lack of communication between the husband and wife. It should have been cleared with the couple what should have been done. Pregnancy management is a couple's decision. it should be solely place on the woman's shoulder.

    The husband should have been an active participant in the whole course of pregnancy so that decisions will be extracted from both of them.

    At the part of the doctor, the doctor should have determined the complication earlier so that proper referral and health measures were provided with a high risk pregnancy as what Lata has.

    At the level of the health officials, they should have been ready for emergency cases such as Lata's. Adequate instruments/materials/products should have been made available at the health facility.

    Angel Ve
    Guest

    Case 2

    Post  Angel Ve on Mon 10 Aug 2009, 11:03 pm

    1. What were some of the causes of Latas death?

    Factors that caused Latas death include her small built, PIH and anemia. Aside from the physiological factors, lack of knowledge also contributed to the condition. Because if Lata is knowledgeable and views her condition as high risk, she would consult and ask the opinion of her husband as to where she would deliver her baby. She assumed that her husband will not pay for the expenses so she just relied on her decision and assumption.

    Another cause would be the inaccessibility of the hospital since it is 40 km away and no transportation was available. Immediate interventions like providing blood transfusion was not provided which caused hypovolemic shock and death.

    railibo-
    Guest

    Re: perinatal nursing: day 1 online discussion

    Post  railibo- on Mon 10 Aug 2009, 11:03 pm

    I agree with thea.. the health workers should have also helped Lata by giving her options. Atleast they could have helped her in making sound judgements with regards to her already risky pregnancy.

    railibo-
    Guest

    Re: perinatal nursing: day 1 online discussion

    Post  railibo- on Mon 10 Aug 2009, 10:58 pm

    Ara, what i meant was Lata's case..that the reason why she did not followed the advise of the health care worker was because she thought that her husband might not afford the hospital bills.

    Althea P
    Guest

    Re: perinatal nursing: day 1 online discussion

    Post  Althea P on Mon 10 Aug 2009, 10:56 pm

    Lata did not follow the advice of the health officer regarding her condition. She didnt even bother to inform her husband with her condition. Also she experienced hemorrhage after giving birth thats why she experienced shock. Again, the distance of the health care facility also contributed to the situation as well as the lack of facilities in the health unit.

    She should have asked for any options and what other actions or treatments she must take. She should have also informed her husband as well as her family members regarding her true condition.
    The husband could have done something by asking other people for help or approaching the government officials for an aide. As for the family, they should have been sensitive enough regarding Latas condition. The health official should have informed the significant others regarding Latas condition and also offered other alternatives and instructed other safety measures.

    ma. cristina arroyo

    Posts : 75
    Join date : 2009-06-24

    Re: perinatal nursing: day 1 online discussion

    Post  ma. cristina arroyo on Mon 10 Aug 2009, 10:56 pm

    First, she is already a high risk of pregnancy. She had history with stillbirth in the past. Considering the fact that the doctor's already advised Lata to seek professional care, yet she still does not adhere to the advise of the patient.

    another factor that plays in this situation is again, the delay in reaching the hospital.

    Another is the lack of supportive materials/products that is needed in times of emergency, in this case, the blood products.

    And also, the health facility that is not accessible from where Lata is.

    arch_ang
    Guest

    Lata's Case

    Post  arch_ang on Mon 10 Aug 2009, 10:54 pm

    Share lang...

    The high prevalence of anemia among women in developing countries predisposes them to PPH, and even a modest blood loss can be
    life threatening.

    The WHO recommends active management of the third stage of labor with uterotonics, preferably oxytocin. However, this use is limited due to the instability of oxytocics in tropical climates and lack of health professionals to administer injectables. More importantly, the greatest risk of maternal death is among women who deliver at home, either alone or with a traditional birth attendant. To date, efforts to reduce maternal mortality through training traditional birth attendants have been disappointing

    Controlling postpartum hemorrhage after home
    births in Tanzania
    N. Prataa,*, G. Mbarukub, M. Campbellc,1, M. Pottsd,2, F. Vahidnia
    17 November 2004

    ara_portillo

    Posts : 74
    Join date : 2009-06-24

    on ate rai's post..

    Post  ara_portillo on Mon 10 Aug 2009, 10:53 pm

    i think in case of amparali.. she had her prenatal check-up but what went wrong in her case is not because she did not follow the advice of the doctor but because of the misdiagnosis.. Very Happy

    railibo-
    Guest

    Re: perinatal nursing: day 1 online discussion

    Post  railibo- on Mon 10 Aug 2009, 10:50 pm

    same as with the case of amparali. let us also include that she never listened to her health care provider about her condition.

    ara_portillo

    Posts : 74
    Join date : 2009-06-24

    on case 2... with regards to loren and dena's post..

    Post  ara_portillo on Mon 10 Aug 2009, 10:44 pm

    yes.. maybe the root cause of her death is the fact that her pregnancy is a high risk one which is neglected by herself and her family members...

    arch_ang
    Guest

    lata's case

    Post  arch_ang on Mon 10 Aug 2009, 10:42 pm

    She is already a high-risk patient. What really complicate her situation is the retained fragments and eventually caused bleeding.
    She should have gone to the district hospital where she can be managed appropriately and can be monitored properly to prevent her from complications.
    The husband should have asked assistance from the hospital or from government agencies that are willing to offer financial aid. They should have worked on the financial aid first given that her wife is a high-risk patient.
    The family should have supported the mother in choosing the district hospital rather than giving birth at home. Truely, lack of information on her condition made her situation worse. Although, i cant blame the family if they choose to have the home delivery because they would rather have food in their table than give birth in the district hospital...(just a thought).
    Health officials should extend do follow-ups on the mother before giving birth to provide necessary care or health teaching in giving birth. They should have presented a hospital plan wherein the family will be persuaded to have the delivery at the district hospital.

    ara_portillo

    Posts : 74
    Join date : 2009-06-24

    on recent post of thea..

    Post  ara_portillo on Mon 10 Aug 2009, 10:40 pm

    yes.. you're right... that is a factor also.. nice...

    anlorrai
    Guest

    Case study 2

    Post  anlorrai on Mon 10 Aug 2009, 10:40 pm

    The causes of Lata's death includes: hemorrhage due to some retained placental fragments and the fact that she is anemic and has a pregnancy induced hypertension.

    Althea P
    Guest

    Re: perinatal nursing: day 1 online discussion

    Post  Althea P on Mon 10 Aug 2009, 10:27 pm

    Some thoughts to ponder, related to Amrapali's case.

    Given the limitations on women's earnings in both formal and informal employment, and their complete exclusion from the cash economy in some cases, the extent to which poor women, particularly those who head households, can afford expenditures [associated with health care] is questionable.

    Because they are financially dependent on husbands or relatives (Mwenesi 1994), women rely on male household members to pay the costs associated with health services. Men usually have the ultimate financial decision-making power about whether or not a family member can go to a health centre (Anyangwe et al. 1994; Kaendi 1994; Tsikata 1994; Vlassoff 1994).

    ara_portillo

    Posts : 74
    Join date : 2009-06-24

    case study 2:

    Post  ara_portillo on Mon 10 Aug 2009, 10:23 pm

    Latas Story
    Lata was 24 years old and lived with her
    husband and in-laws in a remote village. Her husband was a day laborer and the
    familys sole wage-earner. She had been married for three years, and had
    suffered a stillbirth one year earlier. She had become pregnant again, and her
    pregnancy was considered high-risk because she was physically small and had
    anemia and pregnancy-induced hypertension.

    Lata had regular antenatal check-ups at the
    primary health center. Because of her high-risk status and her previous
    stillbirth, the health officer was worried about her, and he advised her to
    deliver at the district hospital. Lata did not think her husband would pay for
    this, however, and so she decided to deliver at home instead. A local private
    doctor attended her delivery, which was very painful and resulted in another
    stillbirth.


    After the birth Lata developed profuse
    bleeding, and she was brought to the primary health center with a retained
    placenta. The medical officer managed to remove the placenta, but Lata had lost
    a dangerous amount of blood and was in a state of shock. Blood transfusion facilities were not
    available at the health center. The nearest hospital was more than 40 km away,
    and there was no transportation available. Latas pulse and blood pressure
    dropped rapidly. The health officer tried very hard but could not save her
    life.

    Questions for Students
    1. What were some of the causes
    of Latas death?
    2. What should she have done
    differently?
    3. Since her husband was the familys sole wage-earner, what should he
    have done to make sure that Lata could receive the treatment she needed?
    4. What should her family have done differently?
    5. What should the health
    officials have done differently?

    ara_portillo

    Posts : 74
    Join date : 2009-06-24

    moving on..

    Post  ara_portillo on Mon 10 Aug 2009, 10:22 pm

    i acknowledged loren and yogi's post.. and yes, i think options for such clients should have been explored with them (the PCSO)...

    let us move to the case study 2?


    Last edited by ara_portillo on Mon 10 Aug 2009, 10:32 pm; edited 2 times in total

    arch_ang
    Guest

    Case1

    Post  arch_ang on Mon 10 Aug 2009, 10:21 pm

    Case # 1

    Every day at least 1,600 women die due to complications related to pregnancy (the majority in developing countries), a total of 585,000 women each year. Nearly 300 million women (more than a quarter of the total adult women in the developing world) suffer from short- or long-term illness or afflictions related to inadequate pre- and post-natal care (Cancino, 2007).
    For Sub-Saharan Africa and Asia, almost 90% of these 1600 death occurs. On the other hand, the mortality rate for industrialized countries, signifying that maternal deaths could be avoided given that resources and services are more available and easy accessibility.
    More than 25,000 women die each year in Latin America and the Caribbean from complications linked to pregnancy and childbirth, and there is an increasingly direct relationship between maternal mortality and poverty (Cancino, 2007).

    Risk Factors:

    Age of more than 20
    Genetic predisposition
    High blood not identified as early as prenatal assessment
    Economic and geographical restrictions
    Health center is cheaper than hospital stay
    Hospital is not so accessible due to the present condition

    In managing hypertensive cases, correct diagnosis by having a complete prenatal assessment and appropriate postpartum care given is imperative. The poor decision made by the husband affected the condition of the mother. The husband or the facility should have done the transferring of the mother to the hospital for prevention and treatment of maternal complications.

    Sponsored content

    Re: perinatal nursing: day 1 online discussion

    Post  Sponsored content


      Current date/time is Tue 24 Oct 2017, 4:35 am