Pregnancy is a happy event for many women, yet it is also a difficult period during which patients experience various changes in their health. Thus, it is the role of a nurse to prepare the patients for pregnancy and childbirth and evaluate their wellbeing to prevent or eliminate any arising issues. In Case Study 1, a 25-year-old female presents to the clinic with the belief that he is pregnant. She has symptoms of breast tenderness and nausea, as well as a pause in her menstrual cycle. Using the calculation based on the first day of the last menstrual period (LMP), one can estimate the due date to be around September 7, 2013 (Schuiling & Likis, 2017). The following plan outlines necessary procedures, tests, and treatments for a comfortable and safe pregnancy.
Plan of Care
First of all, it is vital to confirm the pregnancy and eliminate any differential diagnoses. For this purpose, the nurse has to collect appropriate health history, including the patient’s reproductive history, birth control methods, previous STIs, social history, and any relevant medical concerns (Tharpe, Farley, & Jordan, 2017). Then, such tests as a quantitative B-HCG, urine or serum HCG, TSH, and an ultrasound are performed (Schuiling & Likis, 2017). After establishing that the patient is pregnant, prenatal care planning can begin. The first step is to create a schedule for returning visits – they should occur every 4 to 6 weeks in the first 32 weeks, and 2 to 3 weeks before the 36 week starts. After that period, weekly check-ups are vital to assess the health of the patient and her baby.
The initial evaluation of the pregnant woman’s health includes a comprehensive exam of all vital systems. Diagnostics for STIs, HIV, hepatitis B, varicella, sickle cell, cystic fibrosis, and other conditions ensure that all potential risks are examined (Tharpe et al., 2017). Testing also includes other infections as well as signs of mental health problems, abuse, vitamin deficiencies, malnutrition, and hormonal imbalance (World Health Organization, 2016). As the pregnancy progresses, the patient may have new problems with her health, and appropriate tests should reflect these concerns.
The treatment for the patient relies entirely on her unique challenges. For instance, if she is experiencing nausea that disrupts her usual lifestyle, a nurse can recommend medications and herbal ailments. Nonetheless, most pregnant women are advised to take prenatal vitamins to maintain a healthy level of iron, folic acid, and calcium (World Health Organization, 2016). It is also essential to address the woman’s diet – a healthy diet rich in fibers is a priority. Moreover, vaccinations have to be completed on a schedule, giving an influenza vaccine to patients who either have a respiratory condition or will enter the third trimester in winter and spring months (Tharpe et al., 2017). Pain and symptom relief differ from one patient to another – some women may prefer medications, while others will be more responsive to massage and dietary changes.
Patient Education
The learning for women during pregnancy has to cover expectations, anxieties, partner support, health changes, and other topics. The planned schedule exists to help women gradually become acquainted with their family change, and anticipated testing and examinations need to be discussed during several visits (Bodin, Stern, Käll, Tydén, & Larsson, 2015). Furthermore, the nurse should talk about sexual activity during pregnancy, explain whom to contact in the case of any concerns, and how to handle the childbirth. The importance of exercise, nutrition, and mental wellbeing has to be addressed.
Conclusion
Upon establishing the diagnosis of pregnancy, the patient has to learn much about her health. The nurse’s role is to create a plan that will deliver all required tests, procedures, and education on time, preparing the woman for childbirth and anticipating possible risks. Patient education, in particular, is vital to help the patient to be mentally and physically comfortable and healthy during and after the pregnancy.
References
Bodin, M., Stern, J., Käll, L. F., Tydén, T., & Larsson, M. (2015). Coherence of pregnancy planning within couples expecting a child. Midwifery, 31(10), 973-978.
Schuiling, K. D., & Likis, F. E. (2017). Women’s gynecologic health (3rd ed.). Burlington, MA: Jones and Bartlett Publishers.
Tharpe, N. L., Farley, C., & Jordan, R. G. (2017). Clinical practice guidelines for midwifery & women’s health (5th ed.). Burlington, MA: Jones & Bartlett Publishers.
World Health Organization. (2016). WHO recommendations on antenatal care for a positive pregnancy experience. Web.