case study of oligo

8/11/2019 Case Study of Oligo

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KATHMANDU MEDICAL COLLEGE

Sinamangal, Kathmandu

Case Study of Oligohydramnious

Submitted To : Submitted By : Department of Postnatal Shikshya DhakalMrs. Gayatri Rajbhandari Bs. !ursing "ndyear

!ursing Co#ordinator $thBath


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Acknowledgement

%his ase study report is prepared during my mid&ifery major nursing linial

pratium in '(athmandu Medial College )ospital'. %he report is prepared as a

re*uirement of Bahelor in nursing urriulum &hen + &as posted in postnatal

&ard.

+ had an opportunity to gain e,periene and kno&ledge in this field. + gotmyself ompletely in-ol-ed in the are and management of the patient during the

period. )o&e-er the &ork &ouldnt ha-e been aomplished suessfully &ith my

effort only.

So/ + &ould like to e,press and gi-e a great thank to my teahers &ho are in

the linial area. + am thankful to all the staffs in hospital for kind o#operation. +

am also thankful to my patient and her family for pro-iding me -aluable

information and trusting me. + am also thankful to my olleagues &ho o# operated

&ith me in preparing this ase study.

Shikshya Dhakal

Bs !ursing "ndyear

$thbath

Roll no0 1

"


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Table of contents

Preface

Bakground

Seletion of ase

Objeti-es

Part I

+ntrodution of patient

2. Biographial Data of the patient

". Obstetrial health history of patient

3. Physial 4,amination

Part II

2. +ntrodution of oligohydramnious

". Causes

3. Clinial features

5. Diagnosis

6. +n-estigation7. Compliation

$. Management

1. %reatment

8. +ntrodution of Cesarean Setion

Part III

2. !ursing are plan

". Stress management

3. Disharge %eahing

Postface

Summari9ation

:hat + learnt from this ase study

Referenes

3


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Background

;ording to our urriulum &e ha-e to do one ase study in mid&ifery

pratium/ %his ase study report is prepared as a partial re*uirement of Bahelors in

nursing urriulum of (athmandu uni-ersity.

During 5 &eeks of linial pratie of mid&ifery in Postnatal :ard of (athmandu

Medial ollege hospital/ &e &ere re*uired to do one ase study on high risk ase.

So + ha-e hose the ase of Oligohydramnious '. beause it is one of the ommon

ompliated pregnany ase.

Selection of the case study

2. + am interested to gain kno&ledge about disease Oligohydramnious/ and its

management.

". +t is one of high risk ase.

3. + hose this ase in order to gi-e holisti are to the patient and gi-e health

eduation for promotion and maintenane of life as &ell as pro-ide psyhologial and

emotional support.

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Objectives of case study

%he general objeti-es of ase study are to gain omprehensi-e kno&ledge about diseaseas &ell as pratial e,periene.

The specific objectives are

# %o identify major risk fator of mother.

# %o pro-ide holisti nursing are and management to the patient.

# %o teah mother and family to maintain and promote health of both mother and

baby so that it an minimi9e MMR/ !MR and +MR.

# %o gain omprehensi-e kno&ledge by omparison book &ith real patient.

# %o ollaborate &ith lient families and other health team member in management of

patient.

# %o gain through kno&ledge about oligohydramnious and its management and treatment.

#%o demonstrate skills &hih is needed for mother during hospitali9ation period.

#%o ollaborate &ith patient and other health team members for planning disharge and

folloup -isit.

Introduction of patient

Sita Rai of "7 yrs old/ &ife of Ramesh Rai/ the resident of Balkumari &as admitted inPostnatal :ard on "

Marital status0 Married for " years

)usband !ame0 Ramesh Rai

Religion0 )indu

4duation0 ?iterate @A" PassOupation0 )ouse&ife

;ddress0 Balkumari#1/?alitpur

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Gra-ida=para0 Primi

Date and time of admission0 oli ;id/+ron and alium.

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&istory of family

She has $ family members. )er husband and others family members had no any healthproblem. !o history of P%B/ )%!/ DM or any other medial problem &ith her family.

She has a single family &ith medium soio# eonomi ondition.

Physical '(amination

Physical '(amination

$

)amily Tree

!other Side)ather Side


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Physial e,amination is an important tool in assessing the patients health status.;bout

26 of information used in assessment omes from physial e,amination. +t is

performed to ollet objeti-e data and o#relate it &ith subjeti-e data. +t also re-eals

additional problems &hih the patient has not reogni9ed.

!ethod of physical e(amination

%he ommonly used method of physial e,amination are0

#+nspetion

#Palpation#Perussion

#;usultation

#Measurement

"#% General appearane 0>air

State of health0 )ealthy

Blood pressure0 22

)eight06." ft :eight06"kg

$# %Skin

#Eniform olour and &arm

#!o dehydration

#!o lesion /!o &ound

#!o rashes

*# %&ead and )ace

#Colour and te,ture of hair0 !ormal#)air distribution0 4*ual

#)ead uniform si9e and shape

#!o any injury in head and fae.

+#% 'ye

,ormal in si-e and shape

#Colour of slera0 !ormal

#Pupil reat to light

#Fision0normal

.# % 'ars

#%he top of the pinna met the middle anthus of the eye.

#!o ear disharge

#)earing0 good

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#Slightly &a, present.

/# %,ose

#!o any nasal disharge

#si9e and shape e*ual

#!o polyps /no blokage

0#%!outh1 throat and neck

#olour of lip pink/ moist/ no rak

#%eeth0 no dental arries

#!o gum bleeding

#%ongue moist and pink

#%hyroid not palpable

#Cer-ial lymph node not palpable.

2#% Breast#Both breasts and nipples are symmetrial/ uniform in shape.

#!o tenderness or dipling present.

#!o rak in nipples.

#;u,iliary lymph nodes are not palpable.

3#%Abdomen 4

# !o -isible blood -essels.

# !o any abdominal distension.

#?i-er and spleen are not palpable.

#?inea !igra and striae gra-idarum present

"5#%Arms and 6egs 7'(tremities%

#Both hands and legs are symmetrial.

#!ormal skin olour &ith sensation present.

#!o oedema/ yanosis/ lumbing nails.

#Capillary refill normal.

""#%Anus and )emale genitalia

#!o any disharge from genitalia.

#;nus pattern normal.#!o history of bleeding during defeation.

Systemic '(amination

"# 8hest and 6ungs

#Symmetrial in shape

#Symmetrial in si9e of the breast/ not engorged/ no breast lump.

#Respiration normal and rhythm regular

#Chest lear no &hee9ing sound.

$# 8ardiovascular

#!o ynosis

#!o heart murmur

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#!ormal lubdup sound

*# 9astrointestinal

#;bdominal shape of si9e0 >laid types.

#!o -isible -ein.

#!o abdomen mass

#Bo&el sound present

#?e-er not palpable

#Spleen not palpable

+# 9enitalia

#Slightly bro&n olour disharge

#>oul smelling

#Burning miturition

.# !usculo skeletal

#4asily mobility of hands and legs.

#Musle strength good.

#!o ontrature/ no deformity.

/# ,ervous: !ental

#Patient is fully onsious/ o# operati-e/ speeh lear/ no diffiulty in speaking.

0#Sleeping Pattern

#Before/ sleeping pattern &as normal but no& due to operation/ it is slightly disturbed.

elivery report;

%ype of deli-ery#4mlss

Date and time0 "


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Patients general ondition &as fair. Patient &as in normal diet. Oral mediine started.

!ormal disharge of lohia &as seen.

Post natal e(am

Fitals0#

% 81." >

P 1


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>ooting refle( PresentSucking refle( Good

Swallowing refle( Good

9agging refle( !ot seen or obser-ed.

9rasping1 dancing1 Tonic neck refle(es Present

Babinski refle(# present

evelopmental Task

Sita Rai is "7yrs old she belongs to young adulthood.

2.;ge group#"2 to 38yrs.

".Ioung adulthood is the period of hallenges re&ards and risis.

Challenge of entering the job/ re&ard of a job &ell done and risis assoiated &ith aringof parents and rearing of hildren or family.

;ording to book ;ording to patient

#%he young adults ahie-e

independene from parental ontrol.

4My patient &as totally dependent to her

husband beause she is house&ife.

#%hey begin to delo- strong friendshipand intimate relationship outside the

family.

#She has many friend outside the family.

#%hey establish personal set of -alues. #She has her personal identity and has

established self onept.

#%hey de-elop a sense of personal

identity.

#She had ertain -alues of her life.

4%hey prepare a life &ork and de-elop

the apaity for intimay#

#She got married and her husband is

-ery intimate.

#4stablishing and managing a home and

time shedule and life stress.

#She also manage her home.

#Deide and arry out task of parenting. #She has t&o hildren she perfetly rear

them and she is interested to beome

parent.

isease profile

Oligohydrominous

Introduction

+t is e,tremely rare ondition &here the li*uor amnii defiient in amount of less than

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i :ith poor plaental funtion and fetal gro&th retardation.

ii Seen &ith obstruti-e lesion of the fetal urinary trat and &ith

renal agenies.

iii +n unio-ular t&ins &hen one of the gestation sas has e,ess of

li*uor/ the other sa may ha-e -ery santy li*uor.

'tiology 7according to book%

i ;mnion nodosum0#failure of amnioti fluid seretion.

ii Obstrution of the urinary trat.

iii +GER assoiated &ith plaental insuffiieny

i- Post maturity.

'tiology 7according to patient%

?nknown

iagnosis 7according to patient

i %he uterine si9e appears smaller than gestation period/

ii %here are other features of +EGER.

iii %here may be fetal malpresentation @breeh ommon.

i- On abdominal palpation due to santy li*uor the fetal parts are prominent

and uterus feels full of fetus.

- +t the membranes are artifiially ruptured for indution of labour or there is

spontaneous rupture of the membrane in labour/ there is -ery santy esape

of li*uor &hih is -ery often meonium stained.

-i ?ess fetal mo-ement.

iagonosis during delivery

i %hik meonium stained.

ii Santy li*uor.

iii %he fetal skin is markedly thik dry and lathergy and there e-idene of

fetal deformity.

iagonosis 7according to patient%i Eterine si9e is muh smaller than the period of amenorrhoea.

ii %he uterus is full of fetus beause of santy li*uor.

iii ?ess fetal mo-ement present.

Investigation done in patient

)b#2".3gm=dl

Blood Group#OA-e

FDR?#non#reati-e)+F#negati-e

)BS;G#negati-e

ESG done

BPD Measures#8


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>? Measures#$"mm.

;C Measures#32"mm.

J3$ :OG

+mpression#Single ?i-e >etus :ith Cephali Presentation.

#3$ :OG

#Plaenta ;nterior :all

#?i*uor ;>+ 6m

#4>: 3."(g

'ffect of oligohydramnious

'arly pregnancy

i ;mnioti adhesion or bands may ause deformities like amputation of

fetal limbs or onstrition of the umblial ord.ii Pressure deformities suh as lub feet.

iii Pulmonary hypoplasia has been reported.

i- %he skin beomes dry lethargy and &rinkled.

6ate pregnancy

i +t is sign of fetal jeopardy as in ase +EGR.

ii Close adoption bet&een the fetus and the uterine &all an lead to

pressure on umblial ord and obstrution to the flo& of blood to and

from the fetus. >etal asphy,ia may result.

iii Meoniun passed into a amnioti sa in &hih there is pauity of fluid&ill not be diluted.

i- ;spiration of this thik meonium by the fetus &ill lead to aspiration

pneumonia after birth.

!anagement 7According to book%

%here is no speifi R, for oligohydramnious. +n some ase termination of

pregnany is arried out to forestall se-ere fetal hypo,ia all fetal death in uterus.

!anagement 7According to patient%

!ormal deli-ery &as onduted.

Treatment 7According to book%

Prom is onfirmed labor may be protrated and ontration is more painful.

>etal distress ours fre*uently beause of fre*uent assoiation of fetal malformation

-aginal deli-ery is fa-orable.

Treatment7According to patient%

Prom done

8omplicationA# !aternal

i Prolonged labor due to inertia.

ii +nreased operati-e interferene due to malpresentation

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iii ?ead to maternal mortality.B# )etal

i ;bortion

ii Deformity due to intra#amnioti adhesion or due to ompression

iii >etal distress in labor

i- Cord ompression

- >etal lung hypoplasia

-i Skeletal deformities due to ompression e.g. talipes

-ii >etal mortality is high

rugs used in my patient

#%ab ifran 6


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By +=m=+F

#E%+0+F minor infetion "


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#!ausea/ Fomiting

#;bdominal pain

#Dry mouth/ thirsty

#Poly# urea

#Confusion

#Delirium and oma

,ursing Implication

#%o inrease fluids

#!ot to use antaid unless direted by physiian

#?a,ati-es or stool softeners onstipation ours.

8ap Iron

Action;Replaes iron store/ needed for red blood ell de-elopment/ energy and o,ygen

transport. +t &orks in iron defiieny anaemia/ prophyla,is for +ron defiieny in

pregnany.Dose#5< mg OD

Indication 4 Pregnancy1 Anaemia

Side effects#

#!ausea/ -omiting

#Constipation

#4pigastri pain

#Blak and red torry stools

#diarrhoea#%emporarily disoloured tooth enamel and 4yes.

,ursing Implication

#;ssess blood to,iity/ nausea/ -omiting/ diarrhiea haemat/ oemesis/ pallor/ yanosis/

shok/ oma/ dimination.

Introduction of 8esarean Section

8esarean Section

+t is an operati-e proedure &hereby the fetus after the end of "1th

&eeks is deli-eredthrough an inision on the abdominal and uterine &all. %his e,ludes deli-ery through an

abdominal inision of a fetus lying free in the abdominal a-ity follo&ing rupture of the

uterus.

Indication

Compliations of labor and fators impeding -aginal deli-ery/ suh as0

prolonged labouror a failure to progress @dystoia

fetal distress ord prolapse

uterine rupture

2$
http://en.wikipedia.org/wiki/Childbirthhttp://en.wikipedia.org/wiki/Dystociahttp://en.wikipedia.org/wiki/Fetal_distresshttp://en.wikipedia.org/wiki/Cord_prolapsehttp://en.wikipedia.org/wiki/Uterine_rupturehttp://en.wikipedia.org/wiki/Childbirthhttp://en.wikipedia.org/wiki/Dystociahttp://en.wikipedia.org/wiki/Fetal_distresshttp://en.wikipedia.org/wiki/Cord_prolapsehttp://en.wikipedia.org/wiki/Uterine_rupture


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inreased blood pressure @hypertension in the mother or baby after amnioti

rupture

inreased heart rate @tahyardia in the mother or baby after amnioti

rupture

plaentalproblems @plaenta prae-ia/plaental abruptionorplaenta

areta

abnormal presentation @breehor trans-ersepositions failed labour indution

failed instrumental deli-ery @by forepsor -entouse@Sometimes a trial of

foreps=-entouse deli-ery is attempted/ and if unsuessful/ it &ill be s&ithed

to a Caesarean setion.

large baby &eighing K5


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; patient &ith a uterine a-ity length less than 5 m. %he minimum length of the

eletrode array is 5 m. %reatment of a uterine a-ity &ith a length less than 5 m

&ill result in thermal injury to the endoer-ial anal.

; patient &ith a uterine a-ity &idth less than ".6 m/ as determined by the

:+D%) dial of the disposable de-ie follo&ing de-ie deployment.

; patient &ith ati-e pel-i inflammatory disease.

%ypes of Cesarean Setion

2. 4leti-e Cesarean Setion

". 4mergeny Cesarean Setion

,ursing !anagement

2.Psyhologial support to patient and family.".4nourage to -entilate her feelings.

3.4,plain about the intra#uterine fetal death and possible ompliation.

5.;d-ie to take fre*uent small amount of food it stimulate appetite and digesti-e.

6.;d-ie to take nutritious and iron ontaining food and -egetables.

7.;d-ie about personal hygiene.

$.Control of -isitors and noise near the pts room.

1.Counselling for family planning upto 2#3 yrs spaes minimum.

After elivery1 I assisted my patient to get out of the bed1 ambulation1 e(ercise1

morning care1 changing dresses etc#

+ ga-e health teahing on different topis as neessary. eg. the importane of

ambulation/ rest and e,erise/ diet/ breast feeding/ infetion pre-ention and oral

hygiene et.

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,?>SI,9 8A>' P6A,

S#, ,ursing

iagnosis

,ursing goal ,ursing

implication

>ational 'valuation

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2.

$#

;n,iety

related to

unfamiliarity

&ith hospital

en-ironment

Pain related to

uterine

ontration@pr

ogress of

labourand

desent of

foetus in the

pel-is.

#Pt &ill

e,press

redued

an,iety after

inter-entions.

#patient &ill

ha-e a rela,edbody posture

and faial

e,pression

after

inter-ention.

Patient &ill

ha-e a rela,ed

faial and

body

appearane

bet&een

ontrations.

#Greet patient and

their family

&armly on arri-al.

#Briefly orient

patient about

birthing room/

e,plain anye*uipment that is

inreased inluding

its purpose.

#%alk &ith &omen

about &hat they

e,pet of the birth

e,periene for

e,ample/ ask &ho

they plan on ha-ing

present at birth and

of mediations.

#;ssess for

presene and

harater of pain

ontinuously

during labour

suh as type of

ontration/

fre*ueny and

duration /faial

e,pression /rying

and moaning

during and bet&een

ontrations.

#Pro-ide general

omfort measures

suh as adjust the

room temperature.# 4nourage

&omen to assume

position she finds

most omfortable

other than the

supine.

# Obser-ed for a

full bladder e-ery

one to t&o hrs.

#Makes family feel

&elome and that staff

&ill be onsiderate of

their needs and desires.

#%eahing helps derease

fear related to the

unkno&n and inreases asense of personal ontrol

o-er the situation.

#4nables nursing staff to

help &omen ahie-e their

e,peted e,periene

more losely/ &hih

promotes their

satisfation e-en if all

their e,petations are not

met. %hey &ill probably

be less an,ious of theybelie-e staff ares about

their desires.

# ;ssessment enables to

identify &hether pain is

normal for Patients.

?abour status and it also

helps to identity the best

inter -entions for plain

relief.

# 4-aluating non -erbal

and -erbal

ommuniation helps to

e-aluate need for pain

relief in pt.

# %hese general measures

redue outside irritants.

# Position Changes

promote omfort andhelp the fetus adept to

si9e N shape of pts

pel-is.

# Supine position an

result to redued

plaental blood flo& and

fetal o,ygenation.

#Patient did not

e,press fears.

#patient sits in

bed in

omfortable

position.

Pain is minimi9e

after maintained

pt. position and

psyhologial

support.

"2


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S.!o !sg

diagnosis

Goal +mplementation Rationale 4-aluation

2. ;n,iety

related to

kno&ledge

defiitregarding

pain its

prognosis.

She gained

kno&ledge

about

painmanagement

and its

rela,ation

tehni*ue and

prognosis

2. Reassurane the

patient and -isitors.

". Pro-ide positi-ereinforement

&hen

desired response is

ahie-ed.

3. (eep in omfort

position helps

&hile

turning position.

5. ?isten

attenti-ely/

enourage

-erbali9ation

pro-ide a aring

touh.

6. Gi-e pain killer

mediine

si, hourly or

aording toDotor order.

7. %eah about pain

and

its prognosis.

2. Maintain a good

interpersonal

relationship.

". Positi-e feedbak

helps self onfidene.

3. %hese reassure the

patient that she is not

alone.

5. %hese tehni*ues

allo& an out for an,iety

and help to ontrol pain.

6. %o relie-e operation

site pain.

7. (no&ledge upgrade

and o#operation for her

ondition.

She has

gained

kno&ledge

about painand

rela,ation

tehni*ue .

)er pain

ontrol.

S.!!rsg Diagnosis Goal +mplementation Rationale 4-aluatio

n". Potential to

de-elop

post deli-ery

ompliation.

#hest pain

#Deep -ein

thrombosis

Pre-ent from post

deli-ery

ompliation

during

hospitali9ation.

#%eah deep

breathing

and oughing

e,erise.

#+nstrutions

regarding the

importane of

deep.

#4nourage

e,erise and

ambulation.

#+mpro-e the pulmonary

-entilation/ mobili9es

seretions and stimulate

irulation.

#%eahing regarding

pulmonary mehanis

from foundation of self

are.

#;mbulation maintains

musle tone and pre-ents

musle atrophy andpre-ents thrombophlebitis.

She has

not

de-elops

any post

deli-ery

ompliat

ions so

that my

goal &as

met.

""


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S.!o !sg

Diagn

osis

Goal=Obj

eti-es

!sg

+nter-ention

Rationale 4-aluation

3. )ighrisk

for

infeti

on

2. Patient&ill

remain

free

from

+nfetion

during

hospitali9

ation as

&ell as

at home.

2. Perinealare done 2"

hrly

".4mphasi9ed

or hanging

sanitary pad.

3.Breast are

done daily and

teah

tehni*ue tothe patient.

5.4nourage

to take

nutritional

diet &ith

plenty of

fluids.

6.;d-ie hand

&ashing

before

%ouhing the

baby.

7. ;d-ie for

nail utting.

$. Baby bath

done.

1. 4ye are

and umbilial

are done.

8. ;ntibiotis

as ordered by

dotor

2. +t helps to limit potentialsoure of +nfetion. +t also

pro-ides opportunity to see lohia

and its olour and order take

ation aordingly.

". +t helps to limit potential

soure of +nfetion. +t also

pro-ides opportunity to see lohia

and its olour and order take

ation aordingly

3. +t helps to promote irulation

to lean nipple for baby.5. +t helps to pro-ide body

re*uirement for nutritional and

prompt health status.

6. %o pre-ent ross infetion.

7. %o pre-ent from injury and

infetions.

$. %o obser-e baby skin.

1. %o pre-ent from infetion.

8. Derease possibility of

introduing pathogens.

Mother and baby arefree from infetion

thats &hy objeti-es

&ere fulfilled.

"3


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Stress !anagement

Stress is an unpleasant e,periene of the life. During hospitali9ation patient suffer

from stress beause of ne& en-ironment.

Stress is a hange in the en-ironment that is perei-ed as a threatening hallenging and

damaging to the persons e*uilibrium as dynami balane .:hen stress is more se-ere or

more prolonged than usual/ ho&e-er a person may need a nurses help in oping &ith

stress.

My ase study patient Sita Rai &as suffering from stress due

to hospitali9ation and ne& en-ironment and she &as upsat of her baby.

%o minimi9e her stress/ + follo&ed the follo&ing tehni*ues &hih are as follo&s.

#+ pro-ide plenty of time to e,press her feeling.

#+ ga-e psyhologial support.

#+ built good rapport &ith patient and her family.

#;llo&ed her family member to -isit her.

#Gi-e proper information regarding eah and e-ery proedure.

#Rele-ant information has been gi-en day to day about treatment and prognosis of her

ondition.

Di-ertional therapy has been applied for stress redution &hih are as follo&s0

#%alk therapy

#Pro-iding ne&spaper and other fa-ourate objets.

#;udio=-isual aids/ for e.g. tele-ision.

#+maginary tehni*ue.#+maginary -isuali9ation.

#Distration.

#Progressi-e musle Rela,ation.

#;utogeni training.

"5


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&ealth Teaching:ischarge Teaching

)ealth %eahing plays an important role to pre-ent disease/ promote health as &ell as toure disease more rapidly &ith out any ompliation .one of the most important roles of

the nurse is to pro-ide health eduation. So/ + being a nurse/ + had also gi-en health

eduation to patient and family.

%o promote the health.

%o moti-ate for early diagnosis and treatment.

%o help limit the disability

%o keep in relationship

@eeping above objectives in mind I had given health education to the patient aboutfollowing topics;4

%opis ;d-ie= )ealth 4duation

2.!utrition Postnatal mother needs balane diet &hih should ha-e ade*uate

protein/

arbohydrate/ alium/ iron et. Balane diet helps to regain her health

and

her babys health add to promote health and her babys health add to

promote

health and latation. She must eat 5 times per day &hih is re*uired for

latation.Baby needs good nutrition So mother has to breast feed the hild

regularly till 5#6

month &ithout &ater also. %his is the only one soure of good nutrition

for the baby.

She has to take are about this.

".Rest and

;ti-ities

Rest and sleep is -ery important. So she has to rest in a day also. Sleep

pattern should

be good. ?ight e,erise an be done. ?ifting hea-y thing should be

a-oided. 4speially

post natal e,erise suh as abdominal breathing/ arm raises e,erises.

3.Personal hygiene %his should be done to pre-ent infetion. +nner lothes should be

leaned/ dry and hanged

fre*uently. Periare and breast are should be enouraged.

5.Se,ual +nterourse

and family planning

:e disussed about se,ual interourse and family planning method. +

taught her to pre-ent

some ompliation to the mother and + ad-ie to use temporary family

planning

method &hih she used to like after 56 days beause she &as primipara

mother

6. Care of the baby Gently handling of baby are of eyes/ ears and groins &ith &arm loth/periodi bath and oil

massage/ fre*uently hange of napkin/ hek fre*uently urine and stool

pass.

7. Breast feeding to + ad-ie to teah her about demand feeding/ e,lusi-e breast feeding.

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baby Breast milk seretion

high in amount in night than in day so breast feed in night as &ell as

day. 4,lusi-e breast feeding

help to temporary family planning method.

$.+mmunisation of

baby

+ e,plained about important of +mmunisation and shedule of

+mmunisation and its purpose.

1. Mediine Dotor has presribed the follo&ing mediine. %ab >errous sulphate 2tab OD for 2 month. %ab

Calium 2 tab OD for 2 month. + e,plained about its usefulness.

8. >ollo& up Suggest for importane of routine hek up and health for follo& up

purpose.

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Summari-ation

;ording to our 5 &eeks mid&ifery pratial &e had to do t&o ase studies. + hose the

ase of Oligohydramnious. + got opportunity to obser-e the ases and pro-ide nursing

are aording to need.+ seleted the ase of oligohydramnious. My patient name &as Sita Rai "7 yrs old

admitted in Postnatal :ard &ith the diagnosis of 4mlss for oligohydramnious.

During the &hole period of hospitali9ation + pro-ided holisti nursing are to her

onsidering her mental/ soio#ultural aspets of nursing are.

)er ondition &as impro-ed and reo-ered. So disharged on as per plan. During

hospitali9ation + ga-e health eduation /regarding nutrition/ rest/ breast/ feeding/ e,erise/

regular health hek up and follo& up et.

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28/28

hat I learnt from this case study

>rom this ase study + learnt about oligohydramnious in depth. :hile doing

ase study/ + got many opportunities to gain sientifi kno&ledge and theories in

patient and e-aluate the outomes and finally &rite result. + gained onfidene in

aring and managing the ase of oligohydramnious.Case study helps to gain lot of theoretial as &ell as pratial kno&ledge and it

helps to apply our theoretial kno&ledge in pratial. +t also impro-e &riting

skills. + got hane to study patient and family bakground/ soio#ultural/

en-ironmental bakground of the patient.

>eferences

2. D.C Dutta # %e,t book of obsetris 6th edition

".!ursing drug handbook #28863

3.Manual of mid&itery ;# Roshani %uitui

case study of oligo

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