case study of oligo
TRANSCRIPT
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KATHMANDU MEDICAL COLLEGE
Sinamangal, Kathmandu
Case Study of Oligohydramnious
Submitted To : Submitted By : Department of Postnatal Shikshya DhakalMrs. Gayatri Rajbhandari Bs. !ursing "ndyear
!ursing Co#ordinator $thBath
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Acknowledgement
%his ase study report is prepared during my mid&ifery major nursing linial
pratium in '(athmandu Medial College )ospital'. %he report is prepared as a
re*uirement of Bahelor in nursing urriulum &hen + &as posted in postnatal
&ard.
+ had an opportunity to gain e,periene and kno&ledge in this field. + gotmyself ompletely in-ol-ed in the are and management of the patient during the
period. )o&e-er the &ork &ouldnt ha-e been aomplished suessfully &ith my
effort only.
So/ + &ould like to e,press and gi-e a great thank to my teahers &ho are in
the linial area. + am thankful to all the staffs in hospital for kind o#operation. +
am also thankful to my patient and her family for pro-iding me -aluable
information and trusting me. + am also thankful to my olleagues &ho o# operated
&ith me in preparing this ase study.
Shikshya Dhakal
Bs !ursing "ndyear
$thbath
Roll no0 1
"
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Table of contents
Preface
Bakground
Seletion of ase
Objeti-es
Part I
+ntrodution of patient
2. Biographial Data of the patient
". Obstetrial health history of patient
3. Physial 4,amination
Part II
2. +ntrodution of oligohydramnious
". Causes
3. Clinial features
5. Diagnosis
6. +n-estigation7. Compliation
$. Management
1. %reatment
8. +ntrodution of Cesarean Setion
Part III
2. !ursing are plan
". Stress management
3. Disharge %eahing
Postface
Summari9ation
:hat + learnt from this ase study
Referenes
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Background
;ording to our urriulum &e ha-e to do one ase study in mid&ifery
pratium/ %his ase study report is prepared as a partial re*uirement of Bahelors in
nursing urriulum of (athmandu uni-ersity.
During 5 &eeks of linial pratie of mid&ifery in Postnatal :ard of (athmandu
Medial ollege hospital/ &e &ere re*uired to do one ase study on high risk ase.
So + ha-e hose the ase of Oligohydramnious '. beause it is one of the ommon
ompliated pregnany ase.
Selection of the case study
2. + am interested to gain kno&ledge about disease Oligohydramnious/ and its
management.
". +t is one of high risk ase.
3. + hose this ase in order to gi-e holisti are to the patient and gi-e health
eduation for promotion and maintenane of life as &ell as pro-ide psyhologial and
emotional support.
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Objectives of case study
%he general objeti-es of ase study are to gain omprehensi-e kno&ledge about diseaseas &ell as pratial e,periene.
The specific objectives are
# %o identify major risk fator of mother.
# %o pro-ide holisti nursing are and management to the patient.
# %o teah mother and family to maintain and promote health of both mother and
baby so that it an minimi9e MMR/ !MR and +MR.
# %o gain omprehensi-e kno&ledge by omparison book &ith real patient.
# %o ollaborate &ith lient families and other health team member in management of
patient.
# %o gain through kno&ledge about oligohydramnious and its management and treatment.
#%o demonstrate skills &hih is needed for mother during hospitali9ation period.
#%o ollaborate &ith patient and other health team members for planning disharge and
folloup -isit.
Introduction of patient
Sita Rai of "7 yrs old/ &ife of Ramesh Rai/ the resident of Balkumari &as admitted inPostnatal :ard on "
Marital status0 Married for " years
)usband !ame0 Ramesh Rai
Religion0 )indu
4duation0 ?iterate @A" PassOupation0 )ouse&ife
;ddress0 Balkumari#1/?alitpur
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Gra-ida=para0 Primi
Date and time of admission0 oli ;id/+ron and alium.
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&istory of family
She has $ family members. )er husband and others family members had no any healthproblem. !o history of P%B/ )%!/ DM or any other medial problem &ith her family.
She has a single family &ith medium soio# eonomi ondition.
Physical '(amination
Physical '(amination
$
)amily Tree
!other Side)ather Side
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Physial e,amination is an important tool in assessing the patients health status.;bout
26 of information used in assessment omes from physial e,amination. +t is
performed to ollet objeti-e data and o#relate it &ith subjeti-e data. +t also re-eals
additional problems &hih the patient has not reogni9ed.
!ethod of physical e(amination
%he ommonly used method of physial e,amination are0
#+nspetion
#Palpation#Perussion
#;usultation
#Measurement
"#% General appearane 0>air
State of health0 )ealthy
Blood pressure0 22
)eight06." ft :eight06"kg
$# %Skin
#Eniform olour and &arm
#!o dehydration
#!o lesion /!o &ound
#!o rashes
*# %&ead and )ace
#Colour and te,ture of hair0 !ormal#)air distribution0 4*ual
#)ead uniform si9e and shape
#!o any injury in head and fae.
+#% 'ye
,ormal in si-e and shape
#Colour of slera0 !ormal
#Pupil reat to light
#Fision0normal
.# % 'ars
#%he top of the pinna met the middle anthus of the eye.
#!o ear disharge
#)earing0 good
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#Slightly &a, present.
/# %,ose
#!o any nasal disharge
#si9e and shape e*ual
#!o polyps /no blokage
0#%!outh1 throat and neck
#olour of lip pink/ moist/ no rak
#%eeth0 no dental arries
#!o gum bleeding
#%ongue moist and pink
#%hyroid not palpable
#Cer-ial lymph node not palpable.
2#% Breast#Both breasts and nipples are symmetrial/ uniform in shape.
#!o tenderness or dipling present.
#!o rak in nipples.
#;u,iliary lymph nodes are not palpable.
3#%Abdomen 4
# !o -isible blood -essels.
# !o any abdominal distension.
#?i-er and spleen are not palpable.
#?inea !igra and striae gra-idarum present
"5#%Arms and 6egs 7'(tremities%
#Both hands and legs are symmetrial.
#!ormal skin olour &ith sensation present.
#!o oedema/ yanosis/ lumbing nails.
#Capillary refill normal.
""#%Anus and )emale genitalia
#!o any disharge from genitalia.
#;nus pattern normal.#!o history of bleeding during defeation.
Systemic '(amination
"# 8hest and 6ungs
#Symmetrial in shape
#Symmetrial in si9e of the breast/ not engorged/ no breast lump.
#Respiration normal and rhythm regular
#Chest lear no &hee9ing sound.
$# 8ardiovascular
#!o ynosis
#!o heart murmur
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#!ormal lubdup sound
*# 9astrointestinal
#;bdominal shape of si9e0 >laid types.
#!o -isible -ein.
#!o abdomen mass
#Bo&el sound present
#?e-er not palpable
#Spleen not palpable
+# 9enitalia
#Slightly bro&n olour disharge
#>oul smelling
#Burning miturition
.# !usculo skeletal
#4asily mobility of hands and legs.
#Musle strength good.
#!o ontrature/ no deformity.
/# ,ervous: !ental
#Patient is fully onsious/ o# operati-e/ speeh lear/ no diffiulty in speaking.
0#Sleeping Pattern
#Before/ sleeping pattern &as normal but no& due to operation/ it is slightly disturbed.
elivery report;
%ype of deli-ery#4mlss
Date and time0 "
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Patients general ondition &as fair. Patient &as in normal diet. Oral mediine started.
!ormal disharge of lohia &as seen.
Post natal e(am
Fitals0#
% 81." >
P 1
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>ooting refle( PresentSucking refle( Good
Swallowing refle( Good
9agging refle( !ot seen or obser-ed.
9rasping1 dancing1 Tonic neck refle(es Present
Babinski refle(# present
evelopmental Task
Sita Rai is "7yrs old she belongs to young adulthood.
2.;ge group#"2 to 38yrs.
".Ioung adulthood is the period of hallenges re&ards and risis.
Challenge of entering the job/ re&ard of a job &ell done and risis assoiated &ith aringof parents and rearing of hildren or family.
;ording to book ;ording to patient
#%he young adults ahie-e
independene from parental ontrol.
4My patient &as totally dependent to her
husband beause she is house&ife.
#%hey begin to delo- strong friendshipand intimate relationship outside the
family.
#She has many friend outside the family.
#%hey establish personal set of -alues. #She has her personal identity and has
established self onept.
#%hey de-elop a sense of personal
identity.
#She had ertain -alues of her life.
4%hey prepare a life &ork and de-elop
the apaity for intimay#
#She got married and her husband is
-ery intimate.
#4stablishing and managing a home and
time shedule and life stress.
#She also manage her home.
#Deide and arry out task of parenting. #She has t&o hildren she perfetly rear
them and she is interested to beome
parent.
isease profile
Oligohydrominous
Introduction
+t is e,tremely rare ondition &here the li*uor amnii defiient in amount of less than
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i :ith poor plaental funtion and fetal gro&th retardation.
ii Seen &ith obstruti-e lesion of the fetal urinary trat and &ith
renal agenies.
iii +n unio-ular t&ins &hen one of the gestation sas has e,ess of
li*uor/ the other sa may ha-e -ery santy li*uor.
'tiology 7according to book%
i ;mnion nodosum0#failure of amnioti fluid seretion.
ii Obstrution of the urinary trat.
iii +GER assoiated &ith plaental insuffiieny
i- Post maturity.
'tiology 7according to patient%
?nknown
iagnosis 7according to patient
i %he uterine si9e appears smaller than gestation period/
ii %here are other features of +EGER.
iii %here may be fetal malpresentation @breeh ommon.
i- On abdominal palpation due to santy li*uor the fetal parts are prominent
and uterus feels full of fetus.
- +t the membranes are artifiially ruptured for indution of labour or there is
spontaneous rupture of the membrane in labour/ there is -ery santy esape
of li*uor &hih is -ery often meonium stained.
-i ?ess fetal mo-ement.
iagonosis during delivery
i %hik meonium stained.
ii Santy li*uor.
iii %he fetal skin is markedly thik dry and lathergy and there e-idene of
fetal deformity.
iagonosis 7according to patient%i Eterine si9e is muh smaller than the period of amenorrhoea.
ii %he uterus is full of fetus beause of santy li*uor.
iii ?ess fetal mo-ement present.
Investigation done in patient
)b#2".3gm=dl
Blood Group#OA-e
FDR?#non#reati-e)+F#negati-e
)BS;G#negati-e
ESG done
BPD Measures#8
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>? Measures#$"mm.
;C Measures#32"mm.
J3$ :OG
+mpression#Single ?i-e >etus :ith Cephali Presentation.
#3$ :OG
#Plaenta ;nterior :all
#?i*uor ;>+ 6m
#4>: 3."(g
'ffect of oligohydramnious
'arly pregnancy
i ;mnioti adhesion or bands may ause deformities like amputation of
fetal limbs or onstrition of the umblial ord.ii Pressure deformities suh as lub feet.
iii Pulmonary hypoplasia has been reported.
i- %he skin beomes dry lethargy and &rinkled.
6ate pregnancy
i +t is sign of fetal jeopardy as in ase +EGR.
ii Close adoption bet&een the fetus and the uterine &all an lead to
pressure on umblial ord and obstrution to the flo& of blood to and
from the fetus. >etal asphy,ia may result.
iii Meoniun passed into a amnioti sa in &hih there is pauity of fluid&ill not be diluted.
i- ;spiration of this thik meonium by the fetus &ill lead to aspiration
pneumonia after birth.
!anagement 7According to book%
%here is no speifi R, for oligohydramnious. +n some ase termination of
pregnany is arried out to forestall se-ere fetal hypo,ia all fetal death in uterus.
!anagement 7According to patient%
!ormal deli-ery &as onduted.
Treatment 7According to book%
Prom is onfirmed labor may be protrated and ontration is more painful.
>etal distress ours fre*uently beause of fre*uent assoiation of fetal malformation
-aginal deli-ery is fa-orable.
Treatment7According to patient%
Prom done
8omplicationA# !aternal
i Prolonged labor due to inertia.
ii +nreased operati-e interferene due to malpresentation
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iii ?ead to maternal mortality.B# )etal
i ;bortion
ii Deformity due to intra#amnioti adhesion or due to ompression
iii >etal distress in labor
i- Cord ompression
- >etal lung hypoplasia
-i Skeletal deformities due to ompression e.g. talipes
-ii >etal mortality is high
rugs used in my patient
#%ab ifran 6
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By +=m=+F
#E%+0+F minor infetion "
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#!ausea/ Fomiting
#;bdominal pain
#Dry mouth/ thirsty
#Poly# urea
#Confusion
#Delirium and oma
,ursing Implication
#%o inrease fluids
#!ot to use antaid unless direted by physiian
#?a,ati-es or stool softeners onstipation ours.
8ap Iron
Action;Replaes iron store/ needed for red blood ell de-elopment/ energy and o,ygen
transport. +t &orks in iron defiieny anaemia/ prophyla,is for +ron defiieny in
pregnany.Dose#5< mg OD
Indication 4 Pregnancy1 Anaemia
Side effects#
#!ausea/ -omiting
#Constipation
#4pigastri pain
#Blak and red torry stools
#diarrhoea#%emporarily disoloured tooth enamel and 4yes.
,ursing Implication
#;ssess blood to,iity/ nausea/ -omiting/ diarrhiea haemat/ oemesis/ pallor/ yanosis/
shok/ oma/ dimination.
Introduction of 8esarean Section
8esarean Section
+t is an operati-e proedure &hereby the fetus after the end of "1th
&eeks is deli-eredthrough an inision on the abdominal and uterine &all. %his e,ludes deli-ery through an
abdominal inision of a fetus lying free in the abdominal a-ity follo&ing rupture of the
uterus.
Indication
Compliations of labor and fators impeding -aginal deli-ery/ suh as0
prolonged labouror a failure to progress @dystoia
fetal distress ord prolapse
uterine rupture
2$
http://en.wikipedia.org/wiki/Childbirthhttp://en.wikipedia.org/wiki/Dystociahttp://en.wikipedia.org/wiki/Fetal_distresshttp://en.wikipedia.org/wiki/Cord_prolapsehttp://en.wikipedia.org/wiki/Uterine_rupturehttp://en.wikipedia.org/wiki/Childbirthhttp://en.wikipedia.org/wiki/Dystociahttp://en.wikipedia.org/wiki/Fetal_distresshttp://en.wikipedia.org/wiki/Cord_prolapsehttp://en.wikipedia.org/wiki/Uterine_rupture -
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inreased blood pressure @hypertension in the mother or baby after amnioti
rupture
inreased heart rate @tahyardia in the mother or baby after amnioti
rupture
plaentalproblems @plaenta prae-ia/plaental abruptionorplaenta
areta
abnormal presentation @breehor trans-ersepositions failed labour indution
failed instrumental deli-ery @by forepsor -entouse@Sometimes a trial of
foreps=-entouse deli-ery is attempted/ and if unsuessful/ it &ill be s&ithed
to a Caesarean setion.
large baby &eighing K5
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; patient &ith a uterine a-ity length less than 5 m. %he minimum length of the
eletrode array is 5 m. %reatment of a uterine a-ity &ith a length less than 5 m
&ill result in thermal injury to the endoer-ial anal.
; patient &ith a uterine a-ity &idth less than ".6 m/ as determined by the
:+D%) dial of the disposable de-ie follo&ing de-ie deployment.
; patient &ith ati-e pel-i inflammatory disease.
%ypes of Cesarean Setion
2. 4leti-e Cesarean Setion
". 4mergeny Cesarean Setion
,ursing !anagement
2.Psyhologial support to patient and family.".4nourage to -entilate her feelings.
3.4,plain about the intra#uterine fetal death and possible ompliation.
5.;d-ie to take fre*uent small amount of food it stimulate appetite and digesti-e.
6.;d-ie to take nutritious and iron ontaining food and -egetables.
7.;d-ie about personal hygiene.
$.Control of -isitors and noise near the pts room.
1.Counselling for family planning upto 2#3 yrs spaes minimum.
After elivery1 I assisted my patient to get out of the bed1 ambulation1 e(ercise1
morning care1 changing dresses etc#
+ ga-e health teahing on different topis as neessary. eg. the importane of
ambulation/ rest and e,erise/ diet/ breast feeding/ infetion pre-ention and oral
hygiene et.
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,?>SI,9 8A>' P6A,
S#, ,ursing
iagnosis
,ursing goal ,ursing
implication
>ational 'valuation
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2.
$#
;n,iety
related to
unfamiliarity
&ith hospital
en-ironment
Pain related to
uterine
ontration@pr
ogress of
labourand
desent of
foetus in the
pel-is.
#Pt &ill
e,press
redued
an,iety after
inter-entions.
#patient &ill
ha-e a rela,edbody posture
and faial
e,pression
after
inter-ention.
Patient &ill
ha-e a rela,ed
faial and
body
appearane
bet&een
ontrations.
#Greet patient and
their family
&armly on arri-al.
#Briefly orient
patient about
birthing room/
e,plain anye*uipment that is
inreased inluding
its purpose.
#%alk &ith &omen
about &hat they
e,pet of the birth
e,periene for
e,ample/ ask &ho
they plan on ha-ing
present at birth and
of mediations.
#;ssess for
presene and
harater of pain
ontinuously
during labour
suh as type of
ontration/
fre*ueny and
duration /faial
e,pression /rying
and moaning
during and bet&een
ontrations.
#Pro-ide general
omfort measures
suh as adjust the
room temperature.# 4nourage
&omen to assume
position she finds
most omfortable
other than the
supine.
# Obser-ed for a
full bladder e-ery
one to t&o hrs.
#Makes family feel
&elome and that staff
&ill be onsiderate of
their needs and desires.
#%eahing helps derease
fear related to the
unkno&n and inreases asense of personal ontrol
o-er the situation.
#4nables nursing staff to
help &omen ahie-e their
e,peted e,periene
more losely/ &hih
promotes their
satisfation e-en if all
their e,petations are not
met. %hey &ill probably
be less an,ious of theybelie-e staff ares about
their desires.
# ;ssessment enables to
identify &hether pain is
normal for Patients.
?abour status and it also
helps to identity the best
inter -entions for plain
relief.
# 4-aluating non -erbal
and -erbal
ommuniation helps to
e-aluate need for pain
relief in pt.
# %hese general measures
redue outside irritants.
# Position Changes
promote omfort andhelp the fetus adept to
si9e N shape of pts
pel-is.
# Supine position an
result to redued
plaental blood flo& and
fetal o,ygenation.
#Patient did not
e,press fears.
#patient sits in
bed in
omfortable
position.
Pain is minimi9e
after maintained
pt. position and
psyhologial
support.
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S.!o !sg
diagnosis
Goal +mplementation Rationale 4-aluation
2. ;n,iety
related to
kno&ledge
defiitregarding
pain its
prognosis.
She gained
kno&ledge
about
painmanagement
and its
rela,ation
tehni*ue and
prognosis
2. Reassurane the
patient and -isitors.
". Pro-ide positi-ereinforement
&hen
desired response is
ahie-ed.
3. (eep in omfort
position helps
&hile
turning position.
5. ?isten
attenti-ely/
enourage
-erbali9ation
pro-ide a aring
touh.
6. Gi-e pain killer
mediine
si, hourly or
aording toDotor order.
7. %eah about pain
and
its prognosis.
2. Maintain a good
interpersonal
relationship.
". Positi-e feedbak
helps self onfidene.
3. %hese reassure the
patient that she is not
alone.
5. %hese tehni*ues
allo& an out for an,iety
and help to ontrol pain.
6. %o relie-e operation
site pain.
7. (no&ledge upgrade
and o#operation for her
ondition.
She has
gained
kno&ledge
about painand
rela,ation
tehni*ue .
)er pain
ontrol.
S.!!rsg Diagnosis Goal +mplementation Rationale 4-aluatio
n". Potential to
de-elop
post deli-ery
ompliation.
#hest pain
#Deep -ein
thrombosis
Pre-ent from post
deli-ery
ompliation
during
hospitali9ation.
#%eah deep
breathing
and oughing
e,erise.
#+nstrutions
regarding the
importane of
deep.
#4nourage
e,erise and
ambulation.
#+mpro-e the pulmonary
-entilation/ mobili9es
seretions and stimulate
irulation.
#%eahing regarding
pulmonary mehanis
from foundation of self
are.
#;mbulation maintains
musle tone and pre-ents
musle atrophy andpre-ents thrombophlebitis.
She has
not
de-elops
any post
deli-ery
ompliat
ions so
that my
goal &as
met.
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S.!o !sg
Diagn
osis
Goal=Obj
eti-es
!sg
+nter-ention
Rationale 4-aluation
3. )ighrisk
for
infeti
on
2. Patient&ill
remain
free
from
+nfetion
during
hospitali9
ation as
&ell as
at home.
2. Perinealare done 2"
hrly
".4mphasi9ed
or hanging
sanitary pad.
3.Breast are
done daily and
teah
tehni*ue tothe patient.
5.4nourage
to take
nutritional
diet &ith
plenty of
fluids.
6.;d-ie hand
&ashing
before
%ouhing the
baby.
7. ;d-ie for
nail utting.
$. Baby bath
done.
1. 4ye are
and umbilial
are done.
8. ;ntibiotis
as ordered by
dotor
2. +t helps to limit potentialsoure of +nfetion. +t also
pro-ides opportunity to see lohia
and its olour and order take
ation aordingly.
". +t helps to limit potential
soure of +nfetion. +t also
pro-ides opportunity to see lohia
and its olour and order take
ation aordingly
3. +t helps to promote irulation
to lean nipple for baby.5. +t helps to pro-ide body
re*uirement for nutritional and
prompt health status.
6. %o pre-ent ross infetion.
7. %o pre-ent from injury and
infetions.
$. %o obser-e baby skin.
1. %o pre-ent from infetion.
8. Derease possibility of
introduing pathogens.
Mother and baby arefree from infetion
thats &hy objeti-es
&ere fulfilled.
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Stress !anagement
Stress is an unpleasant e,periene of the life. During hospitali9ation patient suffer
from stress beause of ne& en-ironment.
Stress is a hange in the en-ironment that is perei-ed as a threatening hallenging and
damaging to the persons e*uilibrium as dynami balane .:hen stress is more se-ere or
more prolonged than usual/ ho&e-er a person may need a nurses help in oping &ith
stress.
My ase study patient Sita Rai &as suffering from stress due
to hospitali9ation and ne& en-ironment and she &as upsat of her baby.
%o minimi9e her stress/ + follo&ed the follo&ing tehni*ues &hih are as follo&s.
#+ pro-ide plenty of time to e,press her feeling.
#+ ga-e psyhologial support.
#+ built good rapport &ith patient and her family.
#;llo&ed her family member to -isit her.
#Gi-e proper information regarding eah and e-ery proedure.
#Rele-ant information has been gi-en day to day about treatment and prognosis of her
ondition.
Di-ertional therapy has been applied for stress redution &hih are as follo&s0
#%alk therapy
#Pro-iding ne&spaper and other fa-ourate objets.
#;udio=-isual aids/ for e.g. tele-ision.
#+maginary tehni*ue.#+maginary -isuali9ation.
#Distration.
#Progressi-e musle Rela,ation.
#;utogeni training.
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&ealth Teaching:ischarge Teaching
)ealth %eahing plays an important role to pre-ent disease/ promote health as &ell as toure disease more rapidly &ith out any ompliation .one of the most important roles of
the nurse is to pro-ide health eduation. So/ + being a nurse/ + had also gi-en health
eduation to patient and family.
%o promote the health.
%o moti-ate for early diagnosis and treatment.
%o help limit the disability
%o keep in relationship
@eeping above objectives in mind I had given health education to the patient aboutfollowing topics;4
%opis ;d-ie= )ealth 4duation
2.!utrition Postnatal mother needs balane diet &hih should ha-e ade*uate
protein/
arbohydrate/ alium/ iron et. Balane diet helps to regain her health
and
her babys health add to promote health and her babys health add to
promote
health and latation. She must eat 5 times per day &hih is re*uired for
latation.Baby needs good nutrition So mother has to breast feed the hild
regularly till 5#6
month &ithout &ater also. %his is the only one soure of good nutrition
for the baby.
She has to take are about this.
".Rest and
;ti-ities
Rest and sleep is -ery important. So she has to rest in a day also. Sleep
pattern should
be good. ?ight e,erise an be done. ?ifting hea-y thing should be
a-oided. 4speially
post natal e,erise suh as abdominal breathing/ arm raises e,erises.
3.Personal hygiene %his should be done to pre-ent infetion. +nner lothes should be
leaned/ dry and hanged
fre*uently. Periare and breast are should be enouraged.
5.Se,ual +nterourse
and family planning
:e disussed about se,ual interourse and family planning method. +
taught her to pre-ent
some ompliation to the mother and + ad-ie to use temporary family
planning
method &hih she used to like after 56 days beause she &as primipara
mother
6. Care of the baby Gently handling of baby are of eyes/ ears and groins &ith &arm loth/periodi bath and oil
massage/ fre*uently hange of napkin/ hek fre*uently urine and stool
pass.
7. Breast feeding to + ad-ie to teah her about demand feeding/ e,lusi-e breast feeding.
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baby Breast milk seretion
high in amount in night than in day so breast feed in night as &ell as
day. 4,lusi-e breast feeding
help to temporary family planning method.
$.+mmunisation of
baby
+ e,plained about important of +mmunisation and shedule of
+mmunisation and its purpose.
1. Mediine Dotor has presribed the follo&ing mediine. %ab >errous sulphate 2tab OD for 2 month. %ab
Calium 2 tab OD for 2 month. + e,plained about its usefulness.
8. >ollo& up Suggest for importane of routine hek up and health for follo& up
purpose.
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Summari-ation
;ording to our 5 &eeks mid&ifery pratial &e had to do t&o ase studies. + hose the
ase of Oligohydramnious. + got opportunity to obser-e the ases and pro-ide nursing
are aording to need.+ seleted the ase of oligohydramnious. My patient name &as Sita Rai "7 yrs old
admitted in Postnatal :ard &ith the diagnosis of 4mlss for oligohydramnious.
During the &hole period of hospitali9ation + pro-ided holisti nursing are to her
onsidering her mental/ soio#ultural aspets of nursing are.
)er ondition &as impro-ed and reo-ered. So disharged on as per plan. During
hospitali9ation + ga-e health eduation /regarding nutrition/ rest/ breast/ feeding/ e,erise/
regular health hek up and follo& up et.
"$
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hat I learnt from this case study
>rom this ase study + learnt about oligohydramnious in depth. :hile doing
ase study/ + got many opportunities to gain sientifi kno&ledge and theories in
patient and e-aluate the outomes and finally &rite result. + gained onfidene in
aring and managing the ase of oligohydramnious.Case study helps to gain lot of theoretial as &ell as pratial kno&ledge and it
helps to apply our theoretial kno&ledge in pratial. +t also impro-e &riting
skills. + got hane to study patient and family bakground/ soio#ultural/
en-ironmental bakground of the patient.
>eferences
2. D.C Dutta # %e,t book of obsetris 6th edition
".!ursing drug handbook #28863
3.Manual of mid&itery ;# Roshani %uitui