2 posters
perinatal nursing: day 1 online discussion
ma. cristina arroyo- Posts : 75
Join date : 2009-06-24
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
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
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.
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.
ara_portillo- Posts : 74
Join date : 2009-06-24
- Post n°30
on lata's case..
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
- Post n°31
Case 2
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.
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
- Post n°32
answer case 2
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 Lata’s condition can worsen her condition. I think the family, should have explore more about Lata’s 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
- Post n°33
still on Lata\'s Case....
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
-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
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.
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
- Post n°35
Case 2
1. What were some of the causes of Lata’s death?
Factors that caused Lata’s 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.
Factors that caused Lata’s 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
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
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
Lata did not follow the advice of the health officer regarding her condition. She didn’t even bother to inform her husband with her condition. Also she experienced hemorrhage after giving birth that’s 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 Lata’s condition. The health official should have informed the significant others regarding Lata’s condition and also offered other alternatives and instructed other safety measures.
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 Lata’s condition. The health official should have informed the significant others regarding Lata’s condition and also offered other alternatives and instructed other safety measures.
ma. cristina arroyo- Posts : 75
Join date : 2009-06-24
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.
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
- Post n°40
Lata's Case
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
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
- Post n°41
on ate rai's post..
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..
railibo-- Guest
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
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
- Post n°44
lata's case
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 can’t 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.
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 can’t 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
- Post n°45
on recent post of thea..
yes.. you're right... that is a factor also.. nice...
anlorrai- Guest
- Post n°46
Case study 2
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
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).
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
- Post n°48
case study 2:
Lata’s 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
family’s 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. Lata’s 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 Lata’s death?
2. What should she have done
differently?
3. Since her husband was the family’s 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?
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
family’s 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. Lata’s 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 Lata’s death?
2. What should she have done
differently?
3. Since her husband was the family’s 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
- Post n°49
moving on..
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?
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
- Post n°50
Case1
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.
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.
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