Trauma in Pregnancy
ABSTRACT Although serious trauma during pregnancy is uncommon, it remains a major cause of maternal and fetal death and presents a variety of patient care challenges. The anatomic and physiologic changes of pregnancy can affect both the nature of an injury and the body's response to it. Here, the author describes the mechanisms of traumatic injury during pregnancy, discusses the normal changes of pregnancy and their implications in the care of pregnant trauma patients, and offers strategies for assessment and treatment.
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ABSTRACT: Purpose: To explore the perceptions of labor and delivery nurses caring for women in persistent vegetative states with viable pregnancies. Study design and method: For this qualitative research study, participants included a purposive sample of 13 RNs who provided bedside care to pregnant women in persistent vegetative states. The researchers simultaneously collected and analyzed data from the participants. When the researchers achieved saturation of the data, they presented their results to the participants for corroboration. Results: The nurses reported both knowledge deficits and skill deficits in caring for this patient population. Nurses described emotional responses related to perceived limited support from administration, and reported seeking education from other sources. Although considered experts in labor and delivery care, the obstetrical nurses in this study reported feeling like novices when caring for patients with a diagnosis of persistent vegetative state. The nurses' caregiving concerns were found to originate in their ethical beliefs of beneficence and nonmaleficence. Clinical implications: When a patient presents to an obstetrical unit with an uncommon multidisciplinary severe complication such as vegetative state, the nurses perceived the need for support in order to give the best care. This includes education, a multidisciplinary team approach, and continued instruction throughout the patient's stay. Although nurses consider themselves experts within their practice area, they admit shortcomings when unusual complications are apparent.MCN. The American journal of maternal child nursing 11/2013; 39(2). DOI:10.1097/NMC.0000000000000010 · 0.90 Impact Factor