Maternity Nursing

Maternity Nursing

Traditionally, the diagnosis of pregnancy is made from physical examination and the history of the patient. The nurse must obtain important aspects of the menstrual history. Another test that needs to be done is the enzyme-linked immunosorbent assay (ELISA) which is a quick hCG-determining method. The ELISA uses monoclonal antibodies that are highly specific for hCG with a low sensitivity of 5 mIU/ml. Detection of hCG can be determined several days prior to missed menses. Alternatively, the early pregnancy factor (EPF) can be used instead of determining for β-hCG because it is possible to detect it in the blood before hCG can be detected. EPF is a protein found in the placenta and among the first to appear in blood samples (Ross, 2018). Do you need urgent assignment help ? Get in touch with us at eminencepapers.com.

The nurse will need to advise the patient on the importance of attending prenatal care. Prenatal care is the basis for a healthy pregnancy, labor, and the delivery of a healthy newborn. Regular and early prenatal care is critical for the health of the baby and that of the mother. If any problems arise, then the nurse will be in a position to identify the same and treat these complications in the shortest time possible. When the patient opts not to have prenatal care, she risks her child being born with low birth weight or even dying (Roozbeh, Nahidi, & Hajiyan, 2016).

During each visit, the nurse will talk the mother through the things she needs to do to help herself and the baby stay healthy, such as foods to eat, gaining the right amount of weight, staying active, and what to avoid doing, such as inappropriate dressing and environments to avoid. The nurse may also order blood tests as well as imaging tests. An ultrasound, for example, may be necessitated to see the development of the child and detect any abnormalities. The nurse will also measure the patient’s belly from the pubic bone to the sternum to help determine the baby’s growth. Additionally, during the prenatal visits, the patient will get to discuss with the nurse labor and delivery plans, potential scenarios, and any concerns and questions (Roozbeh, Nahidi, & Hajiyan, 2016). The patient will learn about the advantages and disadvantages of the treatment and interventions that are available to her.

How the Fetus Is Affected by Tobacco Use During Pregnancy and Nursing Interventions in Achieving National 2020 Goals

According to Banderali et al. (2015), smoking while pregnant increases the health problems’ risk for a developing fetus, including low birth weight pre-term birth and development of birth defects of the lip and mouth. Additionally, smoking while pregnant will increase the risk of the fetus’s Sudden Infant Death Syndrome (SIDS) after birth. Tobacco products that contain nicotine, including e-cigarettes, are also not safe. The nicotine can damage the lungs of both the mother and the baby in addition to damaging the brain of the fetus.

The nurse can promote the National 2020 goals (National Conference of State Legislature, n.d) in a number of ways. In attaining longer, high-quality lives that are free of preventable premature death, injury, disability, or disease, the nurse will educate the patients and community on the need to attend prenatal clinics for pregnant women and also on ways of maintaining safe home environments that are conducive for the pregnant woman and the unborn child. The second goal of achieving health equity, eliminating disparities, and improving health for all groups can be achieved through offering basic services for free, such as checking blood glucose and blood pressure, and ensuring that these services are advertised in the community. Vaccination of children should be a campaign focus for the nurse. The third goal is the creation of social and physical environments that will help in the promotion of good health. The nurse, in this case, can organize fitness programs in the community, such as organizing daily walks for the elderly in the community accompanied by the younger persons. This can become a social exercise where the often lonely elderly will get a chance to interact with each other and the younger persons while still gaining some health benefits. Pregnant women will also be encouraged to join these walks to keep fit. The last goal of promoting quality life, healthy behavior, and health developed through all life stages can be achieved through advocacy. The nurse, as an advocate, can petition the local authority to rehabilitate the community recreation centers, making them useable for all persons, including the disabled. The recreation facilities should also be safe enough for children and the elderly to use.

Interview Questions

How is your pregnancy progressing? How are you feeling? What are your thoughts on being pregnant? Is this pregnancy in good timing? Please explain. Have you experienced any changes in your sleep habits or appetite? If yes, What?

Do you have any non-pregnancy-related medical conditions or health problems? If yes, Explain—examples- treatment of mental health issues, HTN, diabetes, etc.

Does your food ever run out before the end of the month, or do you have to cut on the amount you consume so that you can feed others? If so, explain. Are you currently on WIC? Basic Food Program (food stamps)? Do you know of other food programs in your area?

Have you ever smoked or used tobacco or nicotine products? If yes, did you use them during the three months prior to conceiving? Are you currently using tobacco/nicotine? If yes, are you trying to quit? How? Explain. Does anyone smoke tobacco inside your home and/or car?

In the last month, have you had feelings of hopelessness and depression? Have you ever been diagnosed with a mental illness?

Do you have anyone you can count on for help/support during this pregnancy? If so, who? Do you have anyone you can confide in when facing stressful things?

Are you financially ready to have this child? Have you prepared for this child, such as getting your home ready, buying clothes, a baby cot, toys, etc.? If not, when do you plan to do this?

Has your partner or FOB tried to hurt you or physically threatened you within the last 1 year? If yes, explain.

Are you currently taking any prescription drugs, supplements, over-the-counter medications, home remedies, or vitamins? If yes, what are they, and how often do you consume them? Does your physician know you are taking them? If not, why?

List of Nursing Interventions for Promoting Fetal and Maternal Health

Patient-centered care:

Involvement of the family and the patient in care as well as in decision-making at an institutional level

Respect for patient-expressed needs, preferences, and values

Provide patients with accurate information and education through clear and concise communication

Physical comforts such as pain and symptom management

Emotional support and alleviation of anxiety and fear.

Access to care through convenient scheduling (Verbiest, Bonzon, & Handler, 2016)

Teamwork and collaboration:

Coordination and integration of care.

Encourage open-mindedness and cultural competence among team members

Clear and thoughtful communication

Delegate workload and ensure each team member takes care of their responsibilities while remaining organized

Adapting well to change in case of a shift in priorities, obstacles that may delay progress, and occurrence of problems

Ability to tactfully and productively debate ideas with team members (Holt et al., 2017)

Evidence-based practice

Emphasizing psychological well-being and support given by the health practitioners

Emphasizing the importance of the care preferences of the patient being met

Prenatal care to assess the health and wellbeing of the fetus and the mother (Miller et al., 2016)

Quality improvement:

Pharmacist-led medication therapy management to reduce the overall care cost

Optimizing infection care and improving early recognition and patient outcomes.

Compassionate care survey to measure patient satisfaction (WHO, 2016)

Safety

Telemedicine to minimize patient visits to the healthcare facility and reduce opportunities for HAIs.

Medication monitoring for patients taking drugs to control pre-existing health conditions such as HTN and diabetes (Lu et al., 2015).

Informatics:

Encourage patients to fill and update their PHRs

Video calls for patients who have access to the internet

The Four Major Hormones Produced in Early Pregnancy

According to the Stanford Children’s Health Organization (n.d), there are several hormone levels that are affected during pregnancy. The first of these is the human chorionic gonadotropin hormone (hCG) which is only synthesized during pregnancy and is almost solely found in the placenta. In the first trimester, the levels of hCG are elevated in the urine and blood of the mother. This hormone may also be responsible for the vomiting and nausea symptoms linked with first-trimester pregnancy. The second hormone is the human placenta lactogen (hPL), also referred to as the human chorionic somatomammotropin. The hormone is synthesized in the placenta and is responsible for the nourishment of the fetus. The hPL is also responsible for milk gland stimulation for breastfeeding. The third hormone is estrogen which is responsible for the development of sexual traits in females. Estrogen is made in the ovaries in larger amounts than it is in the placenta during pregnancy and helps in maintaining a healthy pregnancy. The last hormone is progesterone which is also majorly made by the ovaries and some by the placenta during pregnancy. Progesterone is responsible for stimulating the uterine lining’s thickening in preparation for the fertilized egg implantation.

 References

Banderali, G., Martelli, A., Landi, M., Moretti, F., Betti, F., Radaelli, G., … & Verduci, E. (2015). Short and long term health effects of parental tobacco smoking during pregnancy and lactation: a descriptive review. Journal of translational medicine, 13(1), 1-7.

Holt, K., Caglia, J. M., Peca, E., Sherry, J. M., & Langer, A. (2017). A call for collaboration on respectful, person-centered health care in family planning and maternal health. Reproductive health, 14(1), 1-3.

Lu, M. C., Highsmith, K., de la Cruz, D., & Atrash, H. K. (2015). Putting the “M” back in the Maternal and Child Health Bureau: reducing maternal mortality and morbidity. Maternal and Child Health Journal, 19(7), 1435-1439.

Miller, S., Abalos, E., Chamillard, M., Ciapponi, A., Colaci, D., Comandé, D., … & Althabe, F. (2016). Beyond too little, too late and too much, too soon: a pathway towards evidence-based, respectful maternity care worldwide. The Lancet, 388(10056), 2176-2192.

National Conference of State Legislators (n.d). Healthy People 2020 and Maternal and Child Health. https://www.ncsl.org/research/health/healthy-people-2020-and-maternal-and-child-health.aspx

Roozbeh, N., Nahidi, F., & Hajiyan, S. (2016). Barriers related to prenatal care utilization among women. Saudi Medical Journal, 37(12), 1319.

Ross, E. (2018). Provisionally pregnant: uncertainty and interpretive work in accounts of home pregnancy testing. Health, 22(1), 87-105.

Soma-Pillay, P., Catherine, N. P., Tolppanen, H., Mebazaa, A., Tolppanen, H., & Mebazaa, A. (2016). Physiological changes in pregnancy. Cardiovascular Journal of Africa, 27(2), 89.

Stanford Children’s Health (n.d). Hormones During Pregnancy. https://www.stanfordchildrens.org/en/topic/default?id=hormones-during-pregnancy-85-P01220

Verbiest, S., Bonzon, E., & Handler, A. (2016). Postpartum health and wellness: A call for quality woman-centered care. Maternal and Child Health Journal, 20(1), 1-7.

World Health Organization. (2016). Standards for improving quality of maternal and newborn care in health facilities.

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Write down sample nursing diagnoses, interventions, and expected outcomes for the following client:

Elaina, 27 years old, visits a prenatal clinic to confirm a positive pregnancy test. Elaina tells the nurse that she is not married and has no support system. She also states that she is making minimum wage at a restaurant with no health insurance and cannot afford prenatal care. She intends to keep the baby and would rather not tell her partner because “they don’t have that kind of a relationship.” Elaina asks the nurse, “If I take good care of myself, why do I need prenatal care?”

#2) Explain how the fetus is affected by tobacco use during pregnancy. Keeping in mind the 2020 National Health Goals, what are some things you can do as a nurse to promote these goals and carry your ideas out into the community?

#3) You are asked to perform an assessment of a pregnant woman and her family. Prior to the assessment, devise a list of interview questions to use to assess the woman’s readiness for parenthood and current health status, as well as her goals for the pregnancy.

#4) For each of the following QSEN competencies, write a list of nursing interventions for promoting fetal and maternal health related to each competency:

Patient-centered care

Teamwork and collaboration

Evidence-based practice

Quality improvement

Safety

Informatics.

#5) List the four major hormones produced in early pregnancy. Describe what each one does.