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Long-term therapy should involve a low-protein diet and arginine supplementation. This diet helps produce equivalent quantities of ornithine for enhancement of urea cycle activity up to the point of argininosuccinate (ASA) lyase and, thus, enhances waste nitrogen incorporation.
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point: Psychodynamic Carlos may be acting out because he is homesick. Carlos' behavior can be explained by his relocation to a new country. Cognitive Carlos may not understand his assignments or environment as well as he did in Spain. This factor could be the cause of his change in behavior.
A boggy uterus, an unexpectedly elevated fundus on palpation, and profuse lochia are all indicators of uterine atony. The nurse must report a PPH right away and get ready to administer intravenous fluids and oxygen while inserting a large-bore intravenous catheter if one isn't already there.
Continue massaging and giving uterotonics to a swampy uterus to promote uterine contraction. Give 20–40 units of oxytocin, an analog of the hormone with the same name found in the body, in 1 L of lactated Ringer (LR) at a rate of 600 mL/h to sustain uterine contraction and manage hemorrhage. (b) Firmly massage the fundus if it is squishy (do not over-massage, this fatigues the muscle). (c) Until the patient's vital signs are stable, check on them every 15 minutes. (d) Avoid bladder enlargement.
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