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PERINATAL LOSS - PERINATALLOSS ....

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PERINATAL LOSS Perinatal loss may occur anytime during gestation or the neonatal period. Usually when pregnancy culminates in  the death of a fetus or neonate, the loss is both unexpected and devastating for the client/couple. The loss of a child that  is wanted can be as traumatic (or even more traumatic) as the loss of a close adult family member or friend. This plan  of care focuses on the emotional needs of the postpartal client who must cope with the death of a child. (To be used in conjunction with routine postpartal plans of care). CLIENT ASSESSMENT DATA BASE Circulation History of essential hypertension, vascular disease Ego Integrity Emotionally labile; anxiety, fear, shock, disbelief, depression Elimination Chronic nephritis Food/Fluid Poor maternal nutritional status Safety Exposure to toxic/teratogenic agents History of traumatic event(s) Presence of pelvic inflammatory disease, sexually transmitted diseases (STDs), or exposure to contagious diseases,  such as rubella, cytomegalovirus, active herpes Premature rupture of membranes Abnormalities of placenta/cord noted at delivery ABO incompatibility Sexuality Bicornate or septate uterus, uterine fibroid tumors (leiomyoma), or other abnormalities of the maternal reproductive  organs Occurrence of traumatic delivery; intrapartal complications Teaching/Learning May report medication, drug (including alcohol) use or abuse Family history of genetic conditions DIAGNOSTIC STUDIES (Refer to CP: Genetic Counseling.) NURSING PRIORITIES 1. Facilitate the grieving process. 2. Provide information regarding events surrounding the loss and future implications.
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DISCHARGE GOALS 1. Supports identified and in place 2. Plans made for disposition of infant’s body 3. Demonstrated progress in dealing with grief at own pace NURSING DIAGNOSIS: GRIEVING [expected] Related To: Death of fetus/infant Possibly Evidenced By: Verbal expression of distress, anger, loss, guilt; crying; alteration in  eating habits or sleep pattern DESIRED OUTCOMES/EVALUATION  Identify and express feelings (e.g., sadness, guilt,  CRITERIA—CLIENT/COUPLE WILL: fear) freely. Acknowledge impact/effect of the grieving process (e.g., physical  problems of eating, sleeping) and seek appropriate help. Participate in self-care activities of daily living (ADLs), as able. Look toward/plan for future, one day at a time. ACTIONS/INTERVENTIONS RATIONALE Independent Code patient’s chart, room door, and/or head  Alerts hospital staff and volunteers so they are  of bed, as indicated. aware of patient’s loss.
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