Case Study-Assessment of Pregnant Client

Case Study-Assessment of Pregnant Client

The following are details of the assessment requirements for a pregnant client. The client is a 37-year-old who presented to the clinic after missing two menstrual cycles. The clinic confirmed that she is ten weeks pregnant. However, some critical issues in her health history need to be considered for her prenatal assessment and care. The following is a summary of the essential  detailsreview for this client. Hire our assignment writing services in case your assignment is devastating you.

Key Considerations Based on the Client’s History

This client has a history of domestic abuse, drug use, sexually transmitted infections, and depression. These are vital considerations that must be taken in her prenatal care. Intimate partner violence is a significant risk factor in pregnancy. It is associated with preterm births and low birth weight (Berhanie et al., 2019). Therefore, it is essential to collaborate with a mental health professional in this patient’s care. The professional will talk to the client and ascertain that she lives in a safe environment without physical or psychological abuse.

This client was also tested positive for HPV. A woman with HPV may worry about the health of their fetus during pregnancy. However, research shows that HPV infection does not cause harm to the pregnancy. There may be worries about the development of warts and abnormal pap smears. There is no cure for HPV; such symptoms can be managed by treating the sign itself (Scheller et al., 2017). The client may also need counseling on other sexually transmitted infections so that she can receive treatment in case of illness.

The client has a history of drug use. She has a history of tobacco and cocaine use. Both of these drugs can risk fetal development and a child’s health. Some of the effects of these drugs could include miscarriage, preterm birth, and low birth weight (Chomchai et al., 2019). Additionally, she has depression, for which she is taking medications. Depression can also affect the development of the pregnancy. The client needs counseling with a professional to stay off the drugs and minimize depression.

Self-Awareness Considerations

As a nurse working with diverse groups of patients, it is easy for care to be affected by personal beliefs and values that are different from those of the client. Therefore, as a professional nurse, I would make the following considerations regarding my self-awareness so that our different beliefs do not affect the patient’s care. First, it is essential to perform a self-assessment. It is important to recognize personal beliefs and values so that one can point out the differences between them and those of the client. Awareness of one’s thoughts helps avoid indirectly projecting them on the client.

Additionally, it is essential to talk to the client and avoid making assumptions. Instead of assuming their beliefs and values, it is necessary to speak to them. The information they give can be positively integrated into the care, and the nurse can also determine the beliefs and practices they can talk to them about to improve the quality of care.

Conditions that may be a Cause of Concern during Pregnancy, Labor, and Birth

One condition that needs special attention is the client’s blood pressure. The client has had chronic hypertension for five years and also has a family history of the same. This makes her a high-risk patient as she may develop hypertension during pregnancy, labor, or birth. Preeclampsia is one of the most common pregnancy complications characterized by high blood pressure (Rana et al., 2019). Therefore, this client will need very close monitoring of her blood pressure. The client also had a caesarian section due to a non-reassuring fetal heartbeat. Therefore, her pregnancy may need close monitoring to avoid similar complications this time round. There is also the issue of drug use. If she continues to use drugs, she might risk the fetus’s life.

Concerns that should be discussed before She Leaves

The first issue that needs to be discussed is her pregnancy risks with hypertension. The client needs to understand the potential risks to her life and the fetus due to her hypertension. This discussion will also include details of the actions that she can take to minimize her blood pressure. The nurse also needs to talk about the drugs. The client should understand the risk of drug use during pregnancy. With this information, she will be less likely to use drugs during pregnancy.

References

Berhanie, E., Gebregziabher, D., Berihu, H., Gerezgiher, A., & Kidane, G. (2019). Intimate partner violence during pregnancy and adverse birth outcomes: a case-control study. Reproductive health, 16(1), 1-9.

Chomchai, S., Phuditshinnapatra, J., Mekavuthikul, P., & Chomchai, C. (2019, April). Effects of unconventional recreational drug use in pregnancy. In Seminars in Fetal and Neonatal Medicine (Vol. 24, No. 2, pp. 142-148). WB Saunders.

Rana, S., Lemoine, E., Granger, J. P., & Karumanchi, S. A. (2019). Preeclampsia: pathophysiology, challenges, and perspectives. Circulation Research, 124(7), 1094-1112.

Scheller, N. M., Pasternak, B., Mølgaard-Nielsen, D., Svanström, H., & Hviid, A. (2017). Quadrivalent HPV vaccination and the risk of adverse pregnancy outcomes. New England journal of medicine, 376(13), 1223-1233.

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Case Study – Assessment of Pregnant Client
Module 03 Content

Case Study-Assessment of Pregnant Client

Purpose of Assignment

Utilize the appropriate technology and references/resources, demonstrating accurate use, to access reliable data and information supporting evidence-based practice in caring for diverse clients during pregnancy.

Differentiate the various components of basic physiological needs related to pregnancy and health practices, including but not limited to associated concepts.

Evaluate data and information gathered during client care, simulated scenarios, and 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 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) in a Women’s OB/GYN Clinic. Elizabeth Jones, 37 years old, presents to the prenatal clinic after missing her last two menstrual cycles. Her home pregnancy test was positive. An ultrasound at the clinic confirms pregnancy. Gestational age is calculated to be ten 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 papillomavirus (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 the 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 when caring for a client with a history of domestic abuse, drug use, sexually transmitted diseases, and depression?
Document the considerations of yourself as a professional nurse regarding self-awareness; be aware of attitudes, values, and beliefs related to clients from different social backgrounds so that care is not affected negatively.
What conditions in Mrs. Jones’s history would cause concern during pregnancy, labor, and birth?
What concerns should be discussed with Ms. Jones before she leaves her appointment?