Sarah Perry

Leah OBrian
N3731: Childbearing & Womens Health Nursing
Postpartum Evaluation Narrative

My patient was brought in to labor and deliver for an induction related to high blood

pressure readings suggesting preeclampsia. She was induced with Pitocin and delivered a baby

boy on (9/20/2016) at 1558 via spontaneous vaginal delivery. Babys APGAR was noted as 9 and

9, and it was also noted that babys cord was wrapped around its shoulder. Post-partum mom was

on a continuous mag sulfate drip to help decrease risk of seizure related to her high blood

pressure. I assumed care and in my care I assessed moms DTR Q2hrs, which were

normoreactive at 2+ throughout the day, along with assessing ankle clonus, adequate intake and

output, any signs of epigastric pain and also any presence of a headache. I also needed to closely

monitor mom as a whole including vitals, breathe sounds, pain as these could all be very

critical depending on the results. In my morning assessment I noticed slight wheezing bilaterally

in the lower portion of the lungs accompanied with a slight headache and elevated BP, because

she was a preeclamptic mom receiving magnesium sulfate, these were not good signs. I then

alerted the primary nurse taking care of her and she gave her pain medication in hopes to

decrease the headache and decrease blood pressure slightly. Due to being on magnesium sulfate

the new mom was placed on bed rest. She had a foley catheter in place to measure adequate urine

output and was repositioned frequently to maintain a position of comfort.

I believe I did a good job in assessing mom and communicating well with my cover

nurse, but I was a little unsure about some things I could and could not do with the patient, one

thing I would have done differently is to have asked if my patient was allowed to get up instead

of just assuming. All in all, mom was a more intensive patient who needed careful monitoring

and I believe I achieved that. I stayed on top of monitoring her vitals/ assessments DTR/ pain. I
sat down and spoke with mom about how she was feeling and any possible needs. I tried to offer

mom relaxation along with coping strategies. One of moms problems that day was she wanted to

get washed up, she wanted to feel a little more human again.

If I were the primary nurse for this patient from admission to discharge, I would have dug

deeper to assess the patients needs for discharge. She has a great support system, however she is

only working as a nurses aide at the moment. And while this can be a great job I know the

struggles of making minimum salary and attempting to support yourself, and then thinking about

bringing a new baby into the picture makes it that much harder. I would have loved to talk to the

mom about possible community sources and government programs that she could easily access

for assistance in care and financial aid for formula, cribs, car seats, diapers, etc.

I really learned a lot from this family and the clinical experience as a whole. The family I

worked with really let me put into perspective the hardships people have to go through. When

you think of a newborn coming into the world it is though to be a happy and precious moment,

however there can be many complications that are devastating to the family. I was able to

witness and actively participate in a pregnancy complication and I could not be more thankful for

the opportunity to work with the nurses and of course the very sweet new mother I sat down and

had real conversation with. I cannot imagine the amount of stress and anxiety that is related to

these types of complications and It makes me really proud to be in the nursing field so I can

assist these patients over the hurdles, and hopefully make a difference in their life.
References for this database:

Lowdermilk, D. L., RNC-E, PhD, FAAN, Perry, S. E., RN, PhD,

FAAN, Cashion, K., RN-BC, MSN, & Alden, K. R., RN, MSN, EdH,

IBCLC. (2016). Maternity & Women's Health Care (11th ed.).

St. Louis, MO: Elsevier.