Nursing Interventions for a Pregnant Client with Complex Medical and Social Histories

Nursing Interventions for a Pregnant Client with Complex Medical and Social Histories

The patient has a history of domestic violence, drug use, sexually transmitted diseases, and depression. When providing care to this patient, the nurse should consider using a holistic care approach. This type of care addresses the needs of the individual as a whole. The patient’s needs can be physical, emotional, social, economic, or spiritual. The nurse should establish a rapport with the patient using good communication skills such as showing empathy and kindness. This will enable the patient to open up and share her concerns. This will lead to the achievement of holistic care(Sainju, 2018). Get in touch with us at eminencepapers.com. We offer assignment help with high professionalism.

The nurse should provide counseling sessions or refer the patient to a psychiatrist or counselor to help her solve her emotional needs. This is relevant if the patient reports that she is angered or traumatized by her past domestic violence experience. Counseling the patient or referring them to counselors and psychiatrists will help solve her problem of depression and promote her emotional well-being during pregnancy(Bailey, 2019). Concerning drug use and STDs, the nurse should provide comprehensive patient education on the demerits of substance abuse during pregnancy(McDonnell & Regan, 2019). The nurse can refer the patient to social help groups that can help the client quit smoking. Safe sexual practices, like using protection, can help avert STDs. Furthermore, both partners should be tested before engaging in any sexual activity.

The nurse should demonstrate self-awareness when dealing with patients from different social backgrounds. For this patient, the nurse’s personal beliefs about STDs and domestic violence should not interfere with care delivery. The nurse should remain non-judgmental by upholding effective communication skills. Stereotyping of patients jeopardizes the nurse-patient relationship and leads to patient dissatisfaction. A multidimensional approach that incorporates holistic care should be used to ensure that the delivery of care is not affected negatively(Cadet et al., 2016). Patients with different spiritual and cultural beliefs will be respected and given the care that fulfills their wishes. This can be achieved by collaborating with other professionals, such as the clergy. Holistic care will help to address the patient as a whole and ensure that all of their needs are fulfilled. Therefore, a multidimensional approach that incorporates holistic care will help to ensure that quality patient care is delivered(Sainju, 2018).

The patient’s history reveals existing comorbidities that create concern for her pregnancy, labor, and delivery. The patient has been hypertensive for five years. Hypertension predisposes the patient to the risk of preeclampsia, eclampsia, and cerebrovascular events. These complications put the mother and the fetus’ well-being at risk. Depression can aggravate the stress that accompanies pregnancy(Yan, 2017). This will affect the other negatively, limit her self-care process, and put the life of the fetus at risk. Depression during pregnancy also predisposes the mother to postpartum depression and impairs her ability to bond with and take care of her baby.

The STD, human papillomavirus, can predispose the patient to the risk of developing cervical cancer and genital warts. Genital warts can interfere with the normal spontaneous vaginal delivery process and warrant a cesarean section. The history of tobacco use, less than five cigarette sticks per day, can predispose the fetus to congenital malformations. Tobacco can lead to defects such as cleft lip and palate and low birth weights(Cope, 2015). It can also predispose the woman to conditions like chronic obstructive pulmonary disease (COPD).

The nurse should address various issues before the patient is discharged. The patient should be educated on the importance of prenatal care(Yan, 2017). She should attend prenatal clinics regularly as scheduled. They help to avert maternal and fetal complications during pregnancy. The patient should be educated on the importance of compliance with her antihypertensive medications. This will lead to adequate control of her blood pressure and reduce accompanying complications.       The patient should be advised on the importance of seeking regular emotional support and drug therapy for her depression. Furthermore, the demerits of tobacco use to the mother a fetus should be explained. The mother should quit smoking to prevent the development of fetal complications and personal problems such as COPD(McDonnell & Regan, 2019).

References

Bailey, J. M. (2019). Prenatal Care Key. Guidelines for Clinical Care Ambulatory Ambulatory.

Cadet, T., Davis, C., Elks, J., & Wilson, P. (2016). A Holistic Model of Care to Support Those Living with and Beyond Cancer. Healthcare, 4(4), 88. https://doi.org/10.3390/healthcare4040088

Cope, G. (2015). How smoking during pregnancy affects the mother and fetus. Nurse Prescribing, 13(6), 282–286. https://doi.org/10.12968/npre.2015.13.6.282

McDonnell, B. P., & Regan, C. (2019). Smoking in pregnancy: pathophysiology of harm and current evidence for monitoring and cessation. The Obstetrician & Gynaecologist, 21(3), 169–175. https://doi.org/10.1111/tog.12585

Sainju, N. K. (2018). Holistic approach to health. Journal of Kathmandu Medical College, 7(1), 1–3. https://doi.org/10.3126/jkmc.v7i1.20620

Yan, J. (2017). The Effects of Prenatal Care Utilization on Maternal Health and Health Behaviors. Health Economics (United Kingdom), 26(8), 1001–1018. https://doi.org/10.1002/hec.3380

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Nursing Interventions for a Pregnant Client with Complex Medical and Social Histories

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.

Module-3-Maternal Assignment

• (+) 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 the first pregnancy, states she has a new partner x 4 years
•  Depression, currently not taking meds for treatment (tx)