Vision: A PREMIER UNIVERSITY

delivering world-class education that promotes Benguet State University “Excellent nursing education that
provides graduates with self-direction,
sustainable development amidst climate
change. COLLEGE OF NURSING competence and compassion.”

Mission: To provide quality education to
enhance food security, sustainable
communities, industry innovation, climate
resilience, gender equality, institutional
development and partnerships.
La Trinidad, Benguet “The College of nursing is committed to
provide a strong academic and
www.bsu.edu.ph/ 422- 2127 professional foundation for the practice
of nursing.”

Enriquez, Angelique Jade C.

Section: BSN III-C, C-14
September 30, 2020
CI: Ma’am Myra Andres

CASE ANALYSIS:

Maitha, 39 year old, female,10 weeks of gestation, was admitted at the Obstetric
Ward. Two days prior to consultation, she had abnormal vaginal bleeding. Ultrasound
shows a presence of an empty sac. The doctor conducted a dilatation and curettage. An
hour after the operation, the patient appeared pale and complains of heavy vaginal
bleeding and difficulty of breathing. The nurse took her vital signs as; BP-90/60mmHg,
PR-99, RR-25 , Tem-37.8, Spo2-89%. The nurse checked the patient’s diaper and it
was soaked with blood after an hour. The doctor ordered oxygen therapy, 1-2L per
nasal cannula. After an hour, the patient still had heavy vaginal bleeding. After some
tests, the doctor ordered blood transfusion and the patient showed improvement after
the blood transfusion. The nurse took the vital signs as; BP-90/60mmHg, RR-19, PR-82,
Tem-37.3, spO2-96%.

I. QUESTIONS:

1. Thirty days post Dilatation and Curettage, Is it recommended for patient Maitha to
have VIA? Why and why not? What are the indications of VIA?

Abnormal vaginal bleeding may be an implication for conditions such as; Polyps
or fibroids in the uterus,lesions, or worst cervical cancer. Yes, VIA should be
recommended to patient Maitha to detect accurate condition and then provide
necessary interventions to avoid/prevent possible complications.

VIA is indicated for all women aging from 30-49years old attending the cervical
cancer screening clinic for the first time, provided the screening protocol recommends
the test. VIA can still be done during menstruation as long as the woman is not bleeding
heavily.

2. Before the doctor conducted D and C, What kind of ultrasound did she have? Why?
Give 3 nursing responsibilities you will perform to patient Maitha in preparing the
ultrasound.
 Vision: A PREMIER UNIVERSITY
delivering world-class education that promotes
sustainable development amidst climate
change.
Benguet State University “Excellent nursing education that
provides graduates with self-direction,
COLLEGE OF NURSING competence and compassion.”

Mission: To provide quality education to
enhance food security, sustainable
communities, industry innovation, climate
resilience, gender equality, institutional
development and partnerships.
La Trinidad, Benguet “The College of nursing is committed to
provide a strong academic and
www.bsu.edu.ph/ 422- 2127 professional foundation for the practice
of nursing.”

Maitha had undergone transvaginal ultrasound to determine causes of abnormal

vaginal bleeding. This procedure uses specially designed transducers inside the vagina
to generate sonogram images,hence, the detection of the empty sac of Maitha in her
10th week of pregnancy.

 Introduce and explain procedure including all rationales of every action.

 Ask patient to remove jewelries, clothing or any other objects that may interfere with
the procedure.
 Instruct patient to empty bladder for her own comfort and for better image results.

3. Give 3 independent nursing interventions addressing the vaginal bleeding.

 Closely monitor vital signs to immediately address complications due to vaginal
bleeding.
 Assist in ADL’s especially in changing diapers.
 Constantly check for leakage of blood from the diaper and change it immediately to
promote patient comfort.

4. What is the purpose of oxygen therapy?

Since Maitha experiences difficulty in breathing and unstable vital signs (low
SPO2) showing oxygen deficit, oxygen therapy was ordered to improve oxygen and
facilitate her breathing.

5. Give 6 nursing responsibilities you will perform before(2), during(2) and after(2)
patient Maitha's Blood Transfusion.

Before:
-Verify doctor’s order. Make sure that it is the right client; inform the client and explain
the purpose of the procedure.

-Check for cross matching and typing to ensure compatibility;check the expiration date
and abnormalities of the blood.

During:
-Monitor vital signs every 15 minutes for the first hour, every 30 minutes for the next
hour and then hourly for the continuing hours.
-Ensure patient safety by raising side rails while closely monitoring adverse reactions
such as chills, vomiting, tachycardia.

After:
-Document relevant data.
-Discard used equipment properly.
 Vision: A PREMIER UNIVERSITY
delivering world-class education that promotes
sustainable development amidst climate
change.
Benguet State University “Excellent nursing education that
provides graduates with self-direction,
COLLEGE OF NURSING competence and compassion.”

Mission: To provide quality education to
enhance food security, sustainable
communities, industry innovation, climate
resilience, gender equality, institutional
development and partnerships.
La Trinidad, Benguet “The College of nursing is committed to
provide a strong academic and
www.bsu.edu.ph/ 422- 2127 professional foundation for the practice
of nursing.”

REFERENCES:

Vera, M., (2016, April 19). Blood Transfusion Therapy Nursing Interventions &
Management. https://nurseslabs.com/blood-transfusion-therapy-nursing-
management/.

Staff, F. E. (2020, August 4). Abnormal Uterine Bleeding: Causes, Diagnosis, and
Treatment. familydoctor.org. https://familydoctor.org/condition/abnormal-uterine-
bleeding/.

Berman, A. T., Snyder, S., & Frandsen, G. (2015). Kozier & Erb's fundamentals of
nursing: Concepts, process, and practice (10th) edition. MACMILLAN
HEINEMANN.

Doenges, M.E., Moorhouse, M.F., Murr, A.C., (2014). Nursing Care Plans.
Guidelines for Individualizing Client Care Across the Life Spa. Edition 9 th. F.A Davis
Company.