Name of Student: Better, Jevee Jean P.

DRUG STUDY

Date Medication Mode of action Dosage Indication(s) Contraindication(s) Side Effects Adverse Effects Nursing Responsibilities
Ordered
October Methylergometrine Methylgometrine Contraindications: CNS: Nervous System: BASELINE ASSESSMENT
11, 2021 acts directly on (Methergin) 1- For the Headache, Tinnitus Determine baseline se
@ the smooth tab TID X 3 prevention  Hypertension Dizziness calcium level, B/P, p
6:00AM muscle of the days PO and control  Toxemia Integumentary: Assess for any evidence
uterus and of excessive  Ergot alkaloid GastrointestinalDiaphoresis bleeding before administrati
increases the For oral dosage bleeding Hypersensitivit :
tone, rate, and form (tablets): following y Abdominal Vascular: INTERVENTION/EVALUAT
amplitude of vaginal Pain, Nausea, Thrombophlebitis  Monitor uterine t
rhythmic ●Adults—0.2 childbirth. Cautions: Diarrhea , Phlebitis bleeding, B/P, p
GENERIC NAME: contractions milligram (mg)  Renal/hepatic q15min until stable (a
Methylergometrine through binding three or four impairment Muscular: Genitourinary: 1–2 hrs.).
and the resultant times a day, for  Cardiovascular Muscle cramps Hematuria  Assess extremities
BRAND NAME: antagonism of the up to 1 week. disease color, warmth, movem
Methergine dopamine D1 ●Children—Use  Occlusive pain.
receptor. Thus, it and dose must peripheral  Report chest
CLASSIFICATION induces a rapid be determined vascular promptly.
: and sustained by your doctor. disease  Provide support
Ergot Alkaloid tetanic uterotonic ambulation if dizzi
 Sepsis
effect which FREQUENCY: occurs.
shortens the third q1-2hr
stage of labor and
reduces blood PATIENT/FAMILY TEACHI
loss.
• Avoid smoking: ca
increased vasoconstriction.
• Report increased cramp
bleeding, foul-smelling lochi
• Report pale, cold hands
(possibility of diminis
circulation)..

REFERENCES:
Drug Bank, (2020). Methylergometrine. https://go.drugbank.com/drugs/DB00353
Mayo Clinic, (2021). Methergine (Oral Route). https://www.mayoclinic.org/drugs-supplements/methergine-oral-route/side-effects/drg-20075636?p=1
Name of Patient: _Patient F.______________________ Date of Admission: October 10, 2021______ Room: _DR__
Age:___29______ Sex: ___F___ Civil Status: _Married Chief of Complaint: Postpartum pain
Religion: __N/A________________________________ Attending Physician: Dr. Dela Cuesta_

NURSING
Date/Time cues Nursing Diagnosis RATIONALE EVALUATION
Goals&Objectives INTERVENTIONS
October Subjective: Nsg Dx. Impaired Breast engorgement can
12, 2021 “Something is Comfort related to be prevented or alleviated “Goal Met”
@ 7:00am wrong with my primary breast After 7 hours of nursing in the following ways: After 7 hours of
breast” as engorgement as intervention the mother will ●Limit using a warm Warm compress may help the nursing intervention
verbalized by evidenced by be able to: compress before mother’s breasts "let down," the mother was be
the patient. verbalization of hard, breastfeeding. If swelling is increasing the flow of milk. This able to:
tender and shiny on both  Feel comfortable observed do not use it. can also increase swelling and
breasts. while breastfeeding. inflammation.  Feel
Objective: comfortable
●Both breasts  Decrease breast ●Breastfeed or pump Reducing the amount of milk in while
are hard, tender engorgement. breasts frequently. the breast and lessen the breastfeeding.
and shiny. engorgement
●Primiparous SCIENTIFIC BASIS  Demonstrate proper  Decrease
mother. Breast engorgement is breastfeeding ●Use cold packs on each The cold packs will help breast
●There is no produced by increased techniques. breast for 5-15 minutes. decrease milk production. It can engorgement
redness, fever, milk production and also help relieve pain and reduce
and cracked blood flow in the days swelling  Demonstrate
nipples. after the delivery of the ●Wear a supportive, well- proper
●Temp: 37 baby. This happens fitting bra but avoid tight bra Wearing tight bra restricts, or breastfeeding
degrees Celsius when a mother produces or clothing. puts pressure on the breasts that techniques.
more milk than her baby can cause a breast infection.
consumes. Increased ●Drink plenty of fluids and
blood flow to the breasts, avoid high-sodium foods Staying hydrated is a good way
aids in milk production, and liquids to keeping milk flowing. Food
but it can also cause rich in high-sodium such as salty
pain and discomfort. foods can increase the swelling
Engorgement may even of the breast.
cause your body ●Alternate breastfeeding
temperature to rise. from either breast. The baby would lessen the
supply of milk from all areas of
the breast and maybe even help
References: to keep the breast from
Hilton, S. (2021). becoming too uneven.
https://www.medela.com
/ Provide health teachings
breastfeeding/mums- about breastfeeding To make sure the mother is
journey/breast- techniques: feeding the baby effectively and
engorgement draining her breasts properly.
●Proper positioning of the
baby: Hold baby- tummy to
tummy, baby's nose and
chin should be placed
against the breast. Correct positioning and
attachment are necessary for
●To have a good effective breastfeeding and the
 attachment make sure that transfer of milk.
baby sucks the areola not
just the nipple. Baby's top
and bottom lip should be
turned out. Baby’s chin
should be pressed into the
breast.

FOCUS DATA ACTION RESPONSE

Impaired Comfort related to
primary breast engorgement
Subjective: ●Breastfeed or pump breasts The mother was able to feel
“Something is wrong with my frequently. comfortable during
breast” as verbalized by the ●Use cold packs on each breastfeeding and was able to
patient. breast for 5-15 minutes. decrease breast
●Wear a supportive, well- engorgement.
fitting bra but avoid tight bra
Objective: or clothing.
●Both breasts are hard, ●Drink plenty of fluids and
tender and shiny. avoid high-sodium foods and
●Primiparous mother liquids
●There is no redness, fever, ●Alternate the breastfeeding
and cracked nipples. from either breast.
●Temp: 37 degrees Celsius

NAME OF STUDENT: Jevee Jean P. Better EVALUATION:

SECTION: BSN2-12A ■Fully Met
□Partially Met
□Unmet

C I am concerned on the mother’s condition on how she reacts and unable to control of her emotions due to the health of
their baby.

U I am uncomfortable with the depressed mood and enormous sense of guilt portrayed by the mother, blaming herself
about the condition of the baby.
 S This is a safety issue because of the mother’s depression that can affect or hinder on the mother’s ability to care or
provide for the baby’s need and at risk for altered parenting. The mother should not feel guilty because she allowed
the child to survive in the first place and chose to keep the infant alive.

Ethico-Moral Legal Considerations:

1. Are you going to attempt to change a woman’s mind about keeping her child or placing the child for adoption?
Why or why not. 
If I were given a chance, I will say yes. It is because as a nurse I have to guide my client in choosing the best decision. I
will attempt once to consider the adoption since I don’t want the mother to regret later on her decision even though her
husband doesn’t support her and the baby. Adoption could not affect herself but also the child’s entire life or development.
As a nurse, I’ll assist her in figuring out how to tell her parents about it, and warn her about the possibility of further
breakdowns.

Nursing Action First, acknowledge the patient’s concern and provide an empathic and trusting
relationship to make the client calm down. Second, attempt to change her mind once
about adoption but not too pushy about it. I would encourage her to verbalize what she felt
and why did she decide to do it and explain to her the best decision to suggest and the
possible consequences of each action. Third, if the client insists to proceed with adoption
asses if she is sure about it once again. If yes respect her decision and provide comfort.
But if not, I would provide her with a list of several options for the financial stability of her
child, such as government assistance and programs that would help her.
Ethical Principle upheld The principle of autonomy is the ethical principle that applies in this situation. The client
has the right to choose decisions and as a nurse, it is our responsibility or job to respect
and support our patient’s decision concerning their health and also for the child.

REFLECTION:

Being a parent is incredibly rewarding, but it's also a lot of work, especially in the beginning. Tina feels scared, upset, disappointed,
fatigued, and overwhelmed in the first few weeks of caring for the newborn, according to the article I read. She anticipated the delightful
experience of getting to know her baby that many new mothers anticipate. Rather, she discovered that she was afraid of her own child. She
cried for what seemed like an eternity because she had no idea how to care for her kid. Tina opted to let the healthcare expert care for the
baby since she was afraid of being an ineffective mother.

For me as a person, it is natural for us to adapt or adjust new things that we’ll be encountering in this world. I’m also adjusting in nursing
program but instead of complaining I just try to manage or face those challenges. It is just like adjusting to parenting wherein there would be
a process of trial and error, good days and bad, and it’s common to take a while to feel comfortable and confident in your new role. After
that it will becomes a habit since we’re used to it.

As a student nurse, postpartum mother especially the new ones are affected physically, emotionally and mentally. As a result, not only is
physical health checked, but the patient as a whole must be assessed and cared for before, during, and after their treatment. Thus,
providing support is key to maintaining their health as well as their newborn’s health, throughout and after their hospital stay to ensure
proper implements have been in place to prevent further or future issues and complications. But since I’m studying online, I can’t able to
demonstrate or even visualize those things.

As health care professional, we should able to support and guide our patients especially the primiparous mothers who lack of experience
and knowledge of child caring. Mothers who contact with a health care professional in the first month after birth can aid them with the
smoother transition and help prevent and treat or care safely the infant and also the mother issues. Even though I am lack of experience I
do have enough knowledge on how to properly care the postpartum mothers.

Postpartum mothers bring about significant changes in women's life; the transition from pregnancy to motherhood can be a challenging
moment that necessitates maternal adaptability as well as physical and emotional balance. It is critical for nurses to understand the
difficulties and demands of these mothers in order to provide qualified effective care to the patient. Nursing care during the postpartum
period is a significant challenge for nurses, as it involves not only the physiological components that women encounter at this time, but also
the psychological aspects and new adaptations to family and work life.

REFERENCE:
Shaw, G. (2021). After Baby is Born: Postpartum Depression and Relationships. https://www.webmd.com/depression/features/postpartum?
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