...This assignment will focus on a short communication between myself and a mother (Caroline) whom I had met three times before, at the antenatal, birth, and six-to-eight week contacts. I had cancelled a three-to-four month visit with her that day on the advice of my mentor. Caroline was an experienced mum and the visit had been mainly to aid my development (Appendix One). She had sounded fine on the phone and had told me she was coming into clinic. Borton’s (1970) reflective model will be used to guide this essay, and I will analyse how the experience has improved my skills in building therapeutic relationships, while recognising areas that require work in order to fulfil my role. All names have been changed to protect confidentiality, as is the responsibility of any registered nurse (NMC 2008). Mental and emotional wellbeing in all family members is intrinsic to the wellbeing of children. The “Healthy Child Programme” (DH 2009) identifies the assessment and promotion of this area as a core part of the health visitor’s role. A common mental health problem that impacts on children is post-natal depression, affecting 10-15% of women (Royal College of Psychiatrists n.d.). Infants whose mothers have post-natal depression often have less positive life outcomes, as discussed in Every Child Matters (HM Treasury 2003). It can impact negatively on emotional, social and mental development, often demonstrated through behavioural problems (Wrate et al., 1985), and neurological problems (Dale...
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...post-partum depression, quite possibly a severe case of schizophrenia. While the reader may believe that the confinement was what had driven her into madness, a closer reading shows the narrator is already completely out of her mind and therefore unreliable from the very onset of the story. Right away the narrator tells us that her husband John doesn’t believe she’s sick. He says she has a “temporary nervous depression” and a “slight hysterical tendency.” The first could possible be a symptom of postpartum depression, which according to the American Congress of Obstetricians and Gynecologists is defined by intense feelings of sadness, fear, anger, and anxiety that interfere with a new mother’s ability to function normally. If left untreated the condition worsens, but nowhere is there any mention of “hysterics.” If we examine the narrator’s journal entries we can easily see that her behavior is a bit more psychotic, even from the very beginning, than a diagnose of postpartum depression would permit. After the reader is filled in on John’s sentiments about the narrator’s current emotional state, she changes the subject as it appears the discourse of her condition upsets her. She then goes on to describe the strange old house where her and John have taken up residency. She describes the “delicious” gardens with “grape covered arbors,” and the dilapidated greenhouse, but once she begins to describe the house itself, she instantly focuses on their bedroom, and then to...
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...Case note on Carmel Collins v Mid-western health Board and O’ Connor This case concerns the death of a man in his early 40’s from a subarachnoid haemorrhage. In the HC the learned trial judge found there to be no action in negligence. The case was appealed to the Supreme Court. The deceased first fell ill on the 20th February 1991 while at work on a building site. He visited the second named defendant in his surgery later that day, after his wife had made an appointment over the phone. She told Dr. O’Connor: “Jim has a very bad headache. He does not usually go to doctors. He must be very bad.” Dr. O’Connor diagnosed the deceased with an upper respiratory tract infection or, in other words, a head cold. On Saturday the 23rd Feb the pf rang Dr. O’Connor to confirm his diagnosis. She told him that she was concerned about her husband who would usually never stay in bed. She asked him to prescribe something for her husband. Dr. O’Connor said the viral flu would just have to take its course. On the 25th February the pf rang the def at 8 am saying ‘Jim is very bad’. The def came around almost immediately and took the view that his headaches were due to sinus congestion. On 5th March, during a conversation regarding another matter, the def was informed the deceased was no better. On 17th March the deceased, still no better, went to see Dr. O’Brien because Dr. O’Connor was not working. Dr O’Brien immediately made an arrangement with the hospital to admit the deceased for a CT scan...
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...Predictors of Postpartum Depression Postpartum depression is a disorder that causes significant functional impairment and develops risks of poor mother-infant bonding and can delay infant development. PPD is “a physical and emotional condition that may be life-threatening, involving the symptoms of depression occurring from a month to one year following childbirth and thought to be caused in part to dramatic hormonal shifts occurring in conjunction with childbirth.” (Piotrowski & Benson, 2017) Postpartum depression symptoms often involve feelings of sadness, restlessness, guilt, insomnia, decreased energy and motivation, unexplained weight changes, frequent crying, irritability, and lessened feelings of self-worth. Research question Recognition...
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...When I was 10 years old, I was treated many times for severe headaches. I was examined by various doctors and was prescribed different medicine every time because none worked. Being prescribed many different medications and never getting a true answer to my chronic headaches, I was always in pain. It was roughly 5 years later during my freshman year in High School when I learned the reason for my headaches. The experience of having a brain tumor completely changed the way I saw life and taught me to not take my life for granted.. It all started when I was 10 years old going from doctor to doctor for my headaches, being told the same thing over and over, that I should take a certain medication for my migraines. However, every time I saw a different doctor I was prescribed a new medication, which had no effect on me and didn’t stop my headache problem. This went on for a few years, going back and forth getting no true answer for my headaches. I would tell my mom that I did not want to go to school because I could not focus at all and she would usually respond, “stop crying it is just a little headache. Take some Tylenol like the doctor said.” She was as clueless about my situation as the doctors were, so I had to suffer the unbearable pain in and out of school. It was not until 5 years later, when I started my freshman year in High School that I realized my motor skills were different and I was failing many classes from not being able to focus in class. One Monday morning when...
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...Review of article: “Statin Use and Risk of Cerebral Aneurysm Rupture: A Hospital-based Case-control Study in Japan,” Y. Yoshimura, Y. Murakami, et al. Design and Data Collection The presented study is a case-control study design, meaning it is based on measuring the associations between statin administration and the likely rupture of a cerebral aneurysm in purposefully selected indicator and control populations. The foundation of the study grew from theoretical components tied to animal models used in the past. The underlying conditions of interest are important but not commonly seen in humans, making it difficult to know the best medical measurements and, if possible, prescriptive interventions for unruptured neurological disorders, which generally now can be dealt with by way of surgical interventions. The written assessment of the study indicated limited evidence of human studies showing the effect of statin drugs in reducing the risk of aneurysmal ruptures. The study model used in this investigation (case-control) is readily suitable to study uncommon diseases with low overall prevalence rates. However, given the impact such a condition could have on a population segment thought to have many years of productivity – and because of promising animal studies – the study was deemed beneficial as an initial step toward learning more about the drug’s beneficial indicators. The primary endpoint of focus was the likelihood of the rupture of an aneurism and the protective effect...
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...Paternal Postpartum Depression Introduction Paternal postpartum depression is a concept that has, only recently, gained some recognition within the mental health community and among clinicians. Male depression and sadness are generally taboos cross culturally. Admitting to depressive symptoms may be considered a sign of weakness, carrying shame and degrading self-worth for men. Due to these stigmas, male depression is significantly under reported comparative to female depression. Defining and quantifying patterns of paternal postpartum depression are the foundation for providing support not only for new fathers, but the family unit as a whole. Statistical Analysis of Prevalence Evidence shows that there is a strong correlation between maternal postpartum depression and that in new fathers. According to one study, 24%-50% of men who experience postpartum depression have depressed partners (Melrose, 2010). Similar statistics have been reviewed in the referenced article Paternal postpartum depression: How can nurses begin to help? by Sherri Melrose. Many of these studies discuss the depressive symptoms of mothers and fathers within the first few months of parenthood. Maternal postpartum depression has been recorded in up to 19.7% of mothers within the first month of giving birth, and fathers are found to be at much greater risk in these cases (Melrose, 2010). Although most of the hormonal data related to pre- & post-natal depression are of female subjects, some...
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...Postpartum Blues vs. Postpartum Depression Having a baby brings lots of emotions including lots of highs and lows, many life changes and physical changes in your body. The changing hormones combined with the stress of caring for a new born affect different people in different ways. ½ to 2/3rds of women experience “Baby Blues” and 10 -15% of women experience postpartum Depression. The chart below will help you understand each and know what to look for and what to do if you think you are experiences either of these. When in doubt always contact your health care provider. | Baby Blues or Postpartum Blues | Postpartum Depression | When Does It Start | The first few days after birth (generally 3rd or 4th day post-delivery) | Anytime up to one year after delivery | How Long Does It Last | From 10 days to several weeks | Lasts longer and is more severe than “baby blues” and needs help from health care provider to resolve | Symptoms | * Mood Changes * Weepiness or sadness * Anxiety * Lack of concentration * Feelings of dependency or inadequacy | * Excessive worrying and anxiety * Irritability * Persistent weepiness or sad mood * Inability to sleep, even when you are exhausted * Difficulty concentrating * Loss of Interest in activities you used to enjoy * Changes in appetite * Thoughts about harming yourself or your baby | Treatment | Talk about it. Take care of yourself by getting rest, support.Usually will resolve with support from friends...
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...Presenting Signs and Symptoms DS, a 55-year-old female, arrived by ambulance to the emergency room on Friday afternoon of October 7, 2011. Patient arrived to Sunrise Hospital complaining of a one-day history of headache with severe intensity that started the night before and became increasingly painful, prompting her to call 911. DS was experiencing difficulty breathing at rest, and altered mental status. In the emergency room, CT scan was done and revealed a large amount of subarachnoid hemorrhage (SAH) in the sylvian fissures and blood in the fourth and third ventricles. DS started suffering from rapid deterioration of mental state and emergency room physician elected to intubate. She was immediately evaluated by a neurosurgeon and he successfully placed a right frontal twist drill for external ventricular drain placement due to the subarachnoid hemorrhage. Pulmonologist was also consulted and aided on the ventilated patient after procedure. Her temperature had been as low as 94.8°F, and she was put on a bear hugger. She was given Propofol titrated to sedation and started on antibiotics. DS was transferred to Neuro ICU on mechanical ventilation and, so far, is currently stable. History and Physical DS has past medical history of emphysema, migraine headaches, and osteoporosis. Her past surgical history includes breast augmentation. DS drinks alcohol on occasion, but denies smoking and recreational drug use. Home medications include ProAir HFA Inhalation...
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...Subarachnoid Hemorrhage Abstract Subarachnoid hemorrhages are more common than the public realizes. Asubarachnoid hemorrhageis a hemorrhage into the cerebrospinal fluid-filled space between the arachnoid and pia membranes on the surface of the brain.Trauma is the most common cause of subarachnoid hemorrhage. Some causes are vehicle accidents, aneurisms, sports, and falls. Some signs and symptoms of subarachnoid hemorrhage include headache, stiff neck, nausea, vomiting, slurred speech, impaired consciousness, loss of consciousness, and seizures. There are various ways of diagnosing subarachnoid hemorrhages among these are MRI, LP, and CT scans. Once discovered a subarachnoid hemorrhage needs to be treated right away. The most important part of treatment is time. The patient’s body must be allowed to attempt to heal on its own. If the hemorrhage does not stop on its own within 24 hours, surgery will be required. People who are conscious and demonstrate few neurologic symptoms when they reach medical help have the best outcome. There are many long term conditions that the individual will have to live with upon survival from fatigue to living in a vegetative state. Traumatic brain injury is the leading cause of subarachnoid hemorrhages, so it follows that efforts to prevent head injury would prevent these hemorrhages. A subarachnoid hemorrhage is a hemorrhage into the cerebrospinal fluid-filled space between the arachnoid and pia membranes on the surface of the brain....
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...June 25, 2012 was the day that changed my life forever. I was awakened around 1:00am by the most horrific noise coming from my husband, Jeff. He was having the most violent seizure I had ever witnessed. I started shaking him and screaming his name in hopes that he would snap out of it, but he remained unresponsive. My hands were shaking so much that I could barely dial 911 for help. It seemed like it took forever for the EMTs to arrive. They immediately began to try and stabilize him but all of their efforts fell short so their focus shifted to getting him to a hospital. It took about forty-five minutes to get him loaded onto a gurney for transport to Trident Regional Medical Center, the closest hospital. Jeff was still seizing when they left in the ambulance. I arrived at the hospital around 2:30am and was informed that the doctor(s) were trying to stabilize Jeff so they could run some tests and scans to try and figure out what was wrong. I decided to call Jeff’s brother, Greg, and let him know what was going on. Greg left work immediately and came to the hospital along with Malinda, their sister. We were summoned to a small, private room where we were greeted not by a doctor, but the hospital chaplain. As he began to talk, my heart sank. Why was he there and not a doctor? He was asking me question after question, but I could not answer him. I finally looked up at him and all I could say was that I wanted to talk to a doctor and that he could leave right then. By this point...
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...Derek and Meredith were getting Zola and Bailey ready for the hospital day care just like any other day, but today was different. They needed to get to the hospital early to start practicing. Meredith and Derek have a special surgery that they are scrubbing in on. This surgery is the first one to be done at Grey Slone Memorial Hospital and Seattle Grace. The head of Neuro at Grey Slone Memorial is Derek Shepherd and in three days he will perform a brain stem Glioma surgery on a six year old. Cancerous Brain Stem Gliomas are nearly impossible to cure with surgery, but the risk is even higher on a child. These type of brain stem surgeries are rarely performed because the brain stem controls your breathing, heart rate, sight, hearing, walking, talking, and eating, so one simple mistake in surgery can paralyze or even kill a person, so this is going to be the start to Derek’s new clinical trial. Derek and Meredith are not the only ones to be in on this surgery, Dr. Avery, Dr. Karev, and Arizona are also scrubbing in along with three interns. So the first two days the seven doctors are practicing on how to reach the tumor and what the best way to take it out is. While they are practicing Dr. Wilson, one of the interns scrubbing in, will be checking on the six year old cancer patient by checking his vitals every 30 minutes making sure the tumor does not erupt. On the second day of practicing, Dr. Wilson notices that the patient's vitals are not very good and goes to tell Dr. Shepherd...
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...Importance of Proper Postpartum Care to Prevent Postpartum Hemorrhage There is a reason for the need of proper postpartum care. Postpartum hemorrhage (PPH) is when there is rapid blood loss after delivery. Post child birth hemorrhage is defined as; more than 500mL blood loss in a vaginal delivery, and more than a 1000mL in a cesarean delivery within 24 hours (McLintcok & James, 2011). Bleeding complications after delivery is the leading cause of morbidity and mortality (Rath, 2011), and causes nearly one quarter of all maternal deaths around the world (Tuncalp, Souza, Gulmezogolu & WHO, 2013). The proper assess and care can prevent maternal death. To prevent PPH a nurse must be aware of the risk factors that can lead to massive blood loss, and interventions that need to be taken to save maternal life. In every delivery there is risks for complications of bleeding whether by identifiable causes or unidentifiable causes; however there are certain situations that increase the risk of postpartum hemorrhage. When determining risks for PPH, it might be helpful to think about the “4 T’s”; tone (uterine atony, distended bladder), trauma (uterine, cervical, or vaginal injury), tissue (retained placenta or clots), thrombin (pre-existing bleeding conditions) (Lalonde, & International Federation of Gynecology and Obstetrics, 2012). There are many risks factors for a nurse to watch for; every delivery uterine atony, incisions or tears, and hyper-coagulopathy put maternal...
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...Objectives: * Recognize common and potentially life-threatening postpartum complications * Postpartum Hemorrhage * Postpartum Endometritis * Peripartum Cardiomyopathy * Postpartum Thyroiditis * Postpartum Depression * Direct the initial management of the ill postpartum patient * Know the appropriate threshold for consultation with specialist Postpartum Hemorrhage * Be defined as a blood loss exceeding 500ml after delivery of the infant * Excessive bleeding that makes the patient symptomatic (lightheaded, syncope) and/or results in signs of hypovolemia (hypotension, tachycardia, oliguria) * PPH: occurs in 24 hour of delivery * the late PPH: occurs after 24 hour of delivery to 6 weeks * Obstetrical emergency that can follow vaginal or cesarean delivery * Incidence – 3% of births * 3rd most common cause of maternal death in US Causes of Postpartum Hemorrhage Four Ts | Cause | Approximate Incidence (%) | Tone | Atonic uterus | 70 | Trauma | Lacerations, Hematomas, Inversion, Rupture | 20 | Tissue | Retained tissue, Invasive placenta | 10 | Thrombin | Coagulopathies | 1 | Risk Factors * Prolonged 3rd stage of labor * Fibroids, placenta previa * Previous PPH * Overdistended uterus * Episiotomy * Use of magnesium sulfate, preeclampsia * Induction or augmentation of labor Management * Secondary steps * Will...
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...1. Which of the following patients are more likely than others to have uterine atony and hemorrhage after delivery? Prolonged labor Primigravidas Hypertensive disorders Pudendal anesthesia for delivery Obesity 2. Which of the following diseases rarely leads to postpartum hemorrhage? A. twin pregnancy B. polyhydramnios C. premature rupture of membrane D. placenta previa E. severe pre-eclampsia 3. A 26-year-old G2 P1 woman underwent a normal vaginal delivery. A viable 3.3kg male infant was delivered. The placenta delivered spontaneously. The obstetrician noted significant blood loss from the vagina, totaling approximately 700 ml. The uterine fundus appeared to be well contracted. Which of the following is the most common etiology for the...
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