No More Worries!

Our orders are delivered strictly on time without delay

Paper Formatting

Double or single-spaced
1-inch margin
12 Font Arial or Times New Roman
300 words per page

No Lateness!

Our orders are delivered strictly on time without delay

Our Guarantees

Free Unlimited revisions
Guaranteed Privacy
Money Return guarantee
Plagiarism Free Writing

Assessment Of A Pregnant Woman

Utilize the appropriate technology and/or references/resources, demonstrating accurate use, in order to access reliable data and information that support evidence-based practice in the care of diverse clients during pregnancy.
Differentiate the various components of basic physiological needs as it relates to pregnancy and health practices, including but not limited to associated concepts of.
Evaluate data and information gathered during client care, simulated scenarios, and/or case studies related to promoting nutritional health during pregnancy, nursing care strategies to address the common discomforts of pregnancy, essential components and standards of prenatal care, fetal growth and development stages in order to determine knowledge and wisdom gained through critical thought processes to optimize client outcomes and quality improvement.
Demonstrate a basic understanding of communication practices necessary for client-centered care and interdisciplinary collaboration in terms of knowledge, skills, and attitudes.
Competency
Apply appropriate nursing care interventions for clients during pregnancy, labor, and birth.

Scenario

You are a registered nurse (RN) working in a Women’s OB/GYN Clinic. Elizabeth Jones, 37 years old, presents to the prenatal clinic after missing her last 2 menstrual cycles. Her home pregnancy test was positive. An ultrasound at the clinic confirms pregnancy. Gestational age is calculated to be 10 weeks. An initial assessment of Ms. Jones’s medical and obstetrical history is as follows.

Obstetric/Gynecologic (OB/GYN) history: Uncomplicated spontaneous vaginal delivery at 39.2 weeks (3 years ago); Cesarean section x 1 at 37.5 weeks for non-reassuring fetal heart tones (1.5 years ago); abnormal Papanicolau (PAP) smear x2, + human papilloma virus (HPV), colposcopy within normal limits

Medical history: Chronic hypertension (HTN) x 5 years;

Allergies: Penicillin

Social history:
(+) tobacco, “occasional” per client (pt), <5 per/day currently, has smoked “off and on” for 15 years (+) cocaine use, states she has not used any cocaine/drugs for > 1 year; (-) alcohol use
Abusive partner with first pregnancy, states she has a new partner x 4 years
Depression, currently not taking meds for treatment (tx)
Medications: Prenatal vitamins; Labetalol 200mg BID;

Family history: Insulin-dependent diabetes mellitus (mother); HTN and heart disease (father); breast cancer (maternal grandmother, deceased)

Instructions
Write a two to three-page analysis of this scenario that answers the following questions:

What should the nurse consider related to caring for a client with a history of domestic abuse, drug use, sexually transmitted diseases and depression?
Document the considerations of yourself as the professional nurse in regards to self-awareness; be aware of attitudes, values and beliefs that you hold related to clients from different social backgrounds so that care is not affected negatively.
What conditions are in Mrs. Jones history that would cause concern during pregnancy, labor, and birth?
What concerns should be discussed with Ms. Jones before she leaves her appointment?

Full Answer Section

Trauma-Informed Care:Acknowledge past abuse and create a safe space for Ms. Jones to express concerns. Demonstrate empathy and avoid judgment.

Drug Use:

Addiction History:Explore the extent of past cocaine use and any withdrawal symptoms. Evaluate cravings and triggers for relapse.
Substance Abuse Treatment:Collaborate with a healthcare provider to develop a safe and effective treatment plan for Ms. Jones during pregnancy.
Support Groups:Connect Ms. Jones with support groups for pregnant women recovering from addiction.

Sexually Transmitted Infections (STIs):

Testing and Treatment:Test Ms. Jones for a comprehensive range of STIs like Chlamydia, Gonorrhea, and HIV considering her history of abnormal PAP smears and HPV. Early diagnosis and treatment minimize risks of complications for both mother and baby.
Partner Notification:Discuss the importance of partner testing and treatment to prevent re-infection.

Depression:

Mental Health Assessment:Evaluate the severity of Ms. Jones' depression and its impact on her daily functioning. Screen for suicidal ideation.
Referrals:Refer Ms. Jones to a mental health professional specializing in perinatal mood disorders for a comprehensive assessment and treatment plan. Consider medication options safe for pregnancy.

Self-Awareness as a Nurse:

Self-reflection:Examine your own biases and assumptions regarding domestic violence, drug use, depression, or social background. Recognize how these biases could influence your care.
Cultural Competency:Provide culturally sensitive care that respects Ms. Jones' values and beliefs.

Conditions of Concern During Pregnancy, Labor, and Birth:

Chronic Hypertension:Closely monitor Ms. Jones' blood pressure throughout pregnancy. Labetalol is generally safe for pregnancy, but dosage adjustments might be needed. Preeclampsia, a pregnancy complication associated with high blood pressure, is a concern.
Previous Cesarean Section:Discuss the possibility of a Vaginal Birth After Cesarean (VBAC) with Ms. Jones. A multidisciplinary team will assess her candidacy for VBAC based on the reasons for the previous C-section and other factors.
Smoking:Smoking significantly increases the risk of pregnancy complications like premature birth, low birth weight, and placental abruption. Encourage Ms. Jones to quit smoking completely with resources like smoking cessation programs.
Depression:Untreated depression can negatively impact prenatal care, self-care, and bonding with the baby. Medication adjustments or alternative therapies might be needed during pregnancy.

Concerns to Discuss Before Discharge:

Prenatal Vitamins:Emphasize the importance of continuing prenatal vitamins for optimal fetal development.
Healthy Diet:Discuss the importance of a balanced diet rich in fruits, vegetables, and whole grains to meet the nutritional needs of pregnancy.
Smoking Cessation:Offer resources and support to help Ms. Jones quit smoking completely.
Mental Health Treatment:Encourage Ms. Jones to follow up with a mental health professional to manage her depression.
Follow-Up Appointments:Schedule regular prenatal appointments to monitor the progress of the pregnancy.

Sample Answer

Considerations for Ms. Jones' Care

Elizabeth Jones' case presents a complex medical and social history requiring comprehensive and compassionate care. Here's a breakdown of key considerations:

Domestic Abuse:

Safety Assessment: As domestic violence can escalate during pregnancy, a confidential safety assessment is crucial. Utilize validated tools like the Hurt, Insult, Threaten, Scream (HITS) questionnaire. Explore partner control behaviors, access to transportation and support systems, and a safe escape plan if needed. Resources like the National Domestic Violence Hotline (1-800-799-7233) can be provided.