Case Study Of Incompetent Cervix

This assignment will critically discuss the nurse’s role in assessment and care planning for a patient in a case study. Confidentiality which is required by the NMC (Nursing Midwifery Council, 2008) and the Data protection Act (1998) will not be broken through out the assignment because the case study used is a scenario not a fictional character. The care plan will focus on Jean’s incontinence needs using The Roper, Logan and Tierney model (2000).

Consequently, cervical damage is another leading cause of long term complications following abortion. Normally the cervix is rigid and tightly closed. In order to perform an abortion, the cervix must be stretched open with a great deal of force. During this forced dilation there is almost always caused microscopic tearing of the cervix muscles and occasionally severe ripping of the uterine wall, as well. About 10% suffer immediate complications; one-fifth are life-threatening: • hemorrhage • infection • ripped or perforated uterus • cervical injury • embolism • anesthesia complications • convulsions • chronic abdominal pain • gastro-intestinal disturbances • endotoxin shock • second-degree burns • Rh

**Placenta previa** is a condition where the placenta blocks the cervix. Sometimes placenta previa has no symptoms at all but can sometimes cause sudden vaginal bleeding, pain in the lower back and abdomen and contractions.

pregnancy. This serious complication results in a miscarriage and can cause death of the mother.

On today’s evaluation, she is 19 weeks and the fetal measurements overall are concordant. The long bone measurements are within one week of her dates. The amniotic fluid volume is normal, and the cervix is long and closed. A complete fetal anatomical survey was performed and a significant amount of ventriculomegaly/hydrocephalous was identified but no other major malformations were noted at this time, though due to the

By dates, the patient is 35 5/7 weeks and the measurements are concordant. The amniotic fluid volume is normal. The fetus is in cephalic presentation. The BPP and Doppler studies are reassuring. A complete fetal anatomical survey was performed and no major malformations were noted at this time within the resolution of the ultrasound equipment other than the fetal abdomen. There is a cystic structure seen in the fetal abdomen that is about 3 cm in diameter with some echolucency surrounding this. It is below the kidney but above the fetal bladder as identified in your office.

Such as in the S for Sleeping Disorders, the nurse found out that patient is having difficulty sleeping, with the assist of pain medication. The nurse requested that she will refer a sleep regiment, and make sure the environment has less distractions. Next was P for Problem with eating, the nurse found out that the patient must eat her food in small pieces, and prefer a soft consistency, and has issue using her eating utensils, due to weakness in her fingers. The nurse recommended the RNA to assist her with that at dinner time. Next, the I for Incontinence, the nurse found out that patient has issue with getting to the bathroom in time before she has an accident. The nurse recommended for patient to have a bathroom regiment and bed side commode. In C for Confusion the nurse found out that due to patient being on pain medication, she is sleeping so much, and she is confused as to where she is, along with the date and time. In E for Evidence of Falls, she assesses history of fall within 6 months and the use of assisted devices, then recommended physical therapy consult due to weakness and strength. In S for Skin Breakdown, the nurse recommended soft care mattress, heel lift boot and frequent skin assessment due to patient concern with her skin easily can

This particular case study involves a 29 year old obstetric patient who presented to the labor and delivery unit at 33 weeks gestation with complaints of abdominal pain for the past three days that had become more severe and absence of fetal movement noted since the previous evening. Her obstetric history revealed she has one living child and has had one previous miscarriage at ten weeks

On today’s ultrasound, a single living IUP is identified with the fetus currently in cephalic presentation with a 3-vessel cord with normal insertion into an anterior right-sided placenta. Fetal biometry today demonstrates an EFW at the 31%ile for reported gestational age. A detailed anatomic survey is without any notable structural abnormalities; however, portions of the fetal face and heart remain to be well visualized due to the fetal position. There was some concern on outside ultrasound for possible cervical shortening and due to this a transvaginal ultrasound was performed that

The patient is an 18 year old Spanish female who came to the unit on 11/31/2016 at 23:10 complaining of cramping and she had thought that her water had broken. Her pain was a 4 on a scale of 0-10 in her abdomen described as cramping. Upon examination she was dilated to 3cm, 80% effaced and the position of the baby was -2 and vertex. Her membranes remained intact. Her estimated due date was 10/28/2016. This is her first pregnancy. She has no history of abortion or miscarriage. She has had her flu vaccine and tdap vaccine in October, 2016. She has never smoked or done illegal drugs. She is negative for group b strep, hepatitis, HIV, and syphilis, gonorrhea, and chlamydia. She is rubella immune. There is a language barrier between the patient and the staff. The patient and her family only speak Spanish and only knew very little

Jane (pseudonym) is a student nurse in the first week of practicum placement in an aged residential care facility. Jane has

On ultrasound there is a live fetus in cephalic presentation. Fetal biometry is consistent with dates. A detailed anatomic survey was fairly unremarkable although slightly suboptimal due to late gestational age. There were no gross abnormalities seen. The placenta is anterior. Amniotic fluid was 8.3 cm. Umbilical artery Doppler was within normal limits.

Patients with early, normal intrauterine pregnancies often present with signs and symptoms similar to those encountered in patients with ectopic pregnancies and other gynecologic or gastrointestinal conditions. The availability of various biochemical, ultrasonographic, and surgical modalities can aid in establishing a definitive diagnosis and differentiating among various conditions. Serum β-HCG levels correlate with the size and gestational age in normal embryonic growth. In a normal pregnancy, the β-HCG level doubles every 48–72 hours until it reaches 10,000–20,000 mIU/mL. In ectopic pregnancies, β-HCG levels usually increase less. Ultrasonography is arguably the most important tool for diagnosing an extrauterine pregnancy, although it is more frequently used to confirm an intrauterine pregnancy. Ultrasonography for a presumed ectopic pregnancy shows an empty uterus on endovaginal ultrasonographic images in patients with a serum beta–human chorionic gonadotropin (β-HCG) level greater than the discriminatory cutoff value is an ectopic pregnancy until proven otherwise. An empty uterus may also represent a recent abortion. In the presence of a definite ectopic pregnancy, a thick, brightly echogenic, ringlike structure is located outside the uterus, with a gestational sac containing an

Current Obstetric & Gynecologic Diagnosis & Treatment-Ninth Ed. DeCherney, Alan H., et al, Ch. 33.

The etiology of the premature ovarian failure remains currently still unknown in most cases, unless referrable to the Turner syndrome or to some medical interventions in oncology (chemotherapy, radiotherapy, etc.). Suggested mechanisms of the ovarian insufficiency rely on either decreased oocyte pool (Broekmans and Dólleman, 2013), augmented follicular atresia (Yu et al., 2004; Ikeda et al., 2014) and altered folliculogenesis (Santoro et al., 2003). The clinical presentation of the ovarian insufficiency may vary significantly. In particular, the serum FSH level and the menstrual cycle appear typically unmodified in the occult ovarian insufficiency, in which only a reduction in fertility coexists. A rise in serum FSH levels with still regular menstrual cycles embodies the diminuished ovarian reserve (DOR). Fertility in this case is compromised. Menstrual cycles become irregular or absent and the serum FSH raises in the overt premature ovarian insufficiency syndrome where fertility, by definition, is seriously compromised (Nelson, 2009).