DAVIS SUCCESS MOTHER BABY

One very important part of this process is the development of the priorities of care. The nurse must determine which diagnoses are the most important and, consequently, which actions are the most important. For example, a client’s physical well-being must take pre- cedence over emotional well-being. It is essential that the nurse consider the client’s priori- ties and the goals and orders of the client’s primary healthcare provider. The nurse caring for the client with placenta previa develops a plan of care based on the diagnoses listed above. Because the physical conditions must take precedence, the nurse prioritizes the plan with the physical needs first. The client’s emotional needs will then be considered. The plan of care to meet the “at risk” nursing diagnoses is shown in Box 1-1, and a plan for the worst-case scenario—active bleeding—is shown in Box 1-2. BOX 1-1 PLAN OF CARE FOR CLIENT WITH PLACENTA PREVIA AT RISK FOR BLEEDING BOX 1-2 PLAN OF CARE FOR PATIENT WITH PLACENTA PREVIA WHO IS BLEEDING continued 6 MATERNAL AND NEWBORN SUCCESS continued BOX 1-2 PLAN OF CARE FOR PATIENT WITH PLACENTA PREVIA WHO IS BLEEDING Implement the Care Once the plan is established, the nurse implements it. The plan may include direct client care by the nurse and/or care that is coordinated by the nurse but performed by other practitioners. If assessment data change during implementation, the nurse must reanalyze the data, change diagnoses, and reprioritize care. One very important aspect of nursing care is that it be evidence based. Nurses are inde- pendent practitioners. They are mandated to provide safe, therapeutic care that has a sci- entific basis. Nurses, therefore, must engage in lifelong learning. It is essential that nurses realize that much of the information in textbooks is outdated before the text was even published. To provide evidence-based care, nurses must keep their knowledge current by accessing information from reliable sources on the Internet, in professional journals, and at professional conferences. Care of the placenta previa patient should be implemented as developed during the planning phase. If a situation should change—for example, should the woman begin to bleed spon- taneously during a shift—the nurse would immediately revise his or her plan, as needed. In the example cited, the nurse would implement the active bleeding plan of care. ............................................CONTINUED.......................................................