Full Answer Section

• Mental Health: Domestic violence can lead to depression, anxiety, and PTSD. Assess Ms. Jones’ mental health and refer her for counseling or mental health services if necessary [ACOG, 2020].

Clinical Example: The nurse asks Ms. Jones privately, “Do you ever feel unsafe at home or have you ever been worried about a partner hurting you?” This approach allows Ms. Jones to disclose abuse without judgment.

Substance Abuse:

Considerations:

• Teratogenicity: Cocaine use during pregnancy can cause birth defects, growth restriction, and preterm birth [Chang et al., 2016]. Assess Ms. Jones’ cocaine use history in detail and refer her for addiction treatment programs focusing on prenatal care [Substance Abuse and Mental Health Services Administration (SAMHSA), 2014].
• Relapse Prevention: Pregnancy can be a trigger for relapse. Develop a collaborative plan with Ms. Jones to identify high-risk situations and coping mechanisms to prevent relapse [SAMHSA, 2014].

Clinical Example: The nurse explains, “Cocaine use during pregnancy can be harmful to the baby. We can connect you with resources to help you stay drug-free throughout your pregnancy.” This approach avoids judgment and focuses on supporting Ms. Jones’ well-being.

Sexually Transmitted Infections (STIs):

Considerations:

• Transmission Risk: Untreated STIs like HPV can increase the risk of cervical cancer and fetal complications [Centers for Disease Control and Prevention (CDC), 2020]. Perform a comprehensive STI screening and treat infections promptly to minimize risks [ACOG, 2020].
• Colposcopy Follow-up: Jones’ history of abnormal Pap smears with HPV warrants colposcopy follow-up to ensure no precancerous lesions are present [American Cancer Society, 2023].

Clinical Example: The nurse explains, “We recommend testing for common STIs to ensure a healthy pregnancy for you and your baby. Early treatment can prevent complications.” This approach emphasizes the benefits of testing for both mother and baby.

Depression:

Considerations:

• Prenatal Depression: Depression during pregnancy can negatively impact both mother and baby’s health. Screen Ms. Jones for depression using standardized tools like the Edinburgh Postnatal Depression Scale (EPDS) [ACOG, 2020]. Refer her for appropriate mental health treatment, considering medication options safe for pregnancy [Beck, 2017].
• Treatment Adherence: Mental health treatment during pregnancy is crucial. The nurse should encourage Ms. Jones to adhere to medication and therapy recommendations and provide support resources [ACOG, 2020].

Clinical Example: The nurse asks Ms. Jones, “Sometimes women experience emotional challenges during pregnancy. Have you ever felt down, hopeless, or unmotivated for most of the day?” This approach opens a dialogue about mental health without stigma.

Self-Awareness and Cultural Competency:

As a healthcare professional, self-awareness of personal biases is crucial to providing culturally competent care. The nurse should reflect on attitudes and beliefs regarding domestic violence, substance abuse, mental health, and social background. Cultural competency training can enhance the nurse’s ability to understand Ms. Jones’ experiences and communicate effectively [American Nurses Association (ANA), 2015].