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Module 03 Case Study – Assessment Of Pregnant Client
Purpose of Assignment
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. Effective communication is essential for client-centered care and interdisciplinary collaboration. In order to provide the best possible care for clients, it is important for healthcare professionals to have good communication skills and to be able to effectively share information and collaborate with other members of the healthcare team. This includes being able to clearly and respectfully communicate with clients, as well as with other healthcare professionals, such as physicians, nurses, and other specialists. Additionally, it is important for healthcare professionals to be able to communicate effectively with clients from diverse backgrounds and to be sensitive to cultural and linguistic differences. Furthermore, healthcare professionals should be able to communicate in a way that is understandable and easy for the client to follow, and should be able to provide clients with clear information about their diagnosis, treatment, and prognosis. Effective communication is important for client-centered care, and interdisciplinary collaboration, as it promotes mutual understanding, shared decision making and better coordination of care, which ultimately results in better patient outcomes.

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?
Each answer to your question should include the following:

A correct answer with thorough development of the topic
Gives clinical examples
Include evidence from scholarly sources
Appropriate use of medical terminology
Format
Standard American English (correct grammar, punctuation, etc.)
Logical, original and insightful
Professional organization, style, and mechanics in APA format
Submit document through Grammarly to correct errors before submission
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Sample Answer Guide:
When caring for a client with a history of domestic abuse, drug use, sexually transmitted diseases, and depression, the nurse should consider a variety of factors to ensure that the client receives appropriate and compassionate care.
First and foremost, the nurse should be aware of the potential for re-traumatization and take steps to create a safe and supportive environment for the client. This may include providing the client with information about available resources, such as crisis hotlines or counseling services, and making sure that the client knows how to access them. Additionally, the nurse should be sensitive to the client’s needs and be willing to adjust their communication style as needed to accommodate the client’s concerns or discomfort.
In terms of drug use, the nurse should be aware of the potential risks and complications associated with drug use during pregnancy, such as preterm labor, low birth weight, and developmental delays, and discuss these risks with the client. Additionally, the nurse should work closely with the client’s healthcare provider to monitor for any potential complications and provide appropriate interventions as needed.
For clients with a history of sexually transmitted diseases, the nurse should be aware of the potential for complications and take steps to prevent the spread of disease. This may include providing the client with information about safe sex practices and referring the client to appropriate resources for testing and treatment.
Finally, for clients with a history of depression, the nurse should be aware of the potential for depression to worsen during pregnancy and take steps to monitor the client’s mental health status. The nurse should also work closely with the client’s healthcare provider to provide appropriate interventions, such as counseling or medication management, as needed.
As a professional nurse, it is important to be aware of one’s own attitudes, values, and beliefs related to clients from different social backgrounds to ensure that care is not negatively affected. For example, a nurse who holds negative attitudes towards clients with a history of drug use may be less likely to provide appropriate and compassionate care. To counteract this, the nurse should strive to maintain a non-judgmental attitude and be willing to educate themselves about the client’s specific experiences and needs.
In terms of Mrs. Jones’ history, her chronic hypertension and history of cesarean section would be cause for concern during pregnancy, labor, and birth. Her hypertension may increase her risk of preeclampsia, and her history of cesarean section may increase her risk of complications during labor and delivery.
Before Ms. Jones leaves her appointment, the nurse should discuss her concerns with her, including the risks associated with her hypertension and history of cesarean section, as well as the potential risks associated with her history of drug use and depression. The nurse should also provide Ms. Jones with information about available resources, such as counseling services or support groups, and make sure that she knows how to access them. Additionally, the nurse should discuss any necessary follow-up care or tests with Ms. Jones, such as monitoring her blood pressure or scheduling a follow-up ultrasound.
Caring for a client with a history of domestic abuse, drug use, sexually transmitted diseases, and depression requires the nurse to be aware of the potential risks and complications, and take steps to provide appropriate and compassionate care. It is important for the nurse to be aware of their own attitudes and beliefs related to clients from different social backgrounds and to work closely with the client’s healthcare provider to provide appropriate interventions as needed.

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