Mother: Kayla
Gestational diabetes (E11.9)
Gestation diabetes is a condition that occurs in women and causes hormonal imbalances during pregnancy. Gestation diabetes might result in miscarriage and early birth when managed poorly. The condition becomes worse when the patient has poor eating habits, does not take medication or frequency does physical exercise (Schuiling & Likis, 2013). The condition causes high blood sugar in a pregnant woman and affects the health of the baby or pregnancy. When the condition fails to clear after pregnancy, it might develop into type 2 diabetes (Schuiling & Likis, 2013). In the case of Kayla, she has had a miscarriage, early birth, and is currently experiencing unpredictable menses. The patient has gestation diabetes under her list of ailments at the clinic.
Stress (F.32.9)
This is a disorder in the mood making a patient be lack sleep, feel sad, and overreact to minor issues (Hay, Levin, Deterding, & Abzug, 2014). Apparently, Kayla states that she is experiencing problems with sleep because she is worried about her children as a result of the impending divorce. She overreacts by applying excessive force in handling the toddler. She feels sad and desperate to control her teenage daughter who has refused to accompany her to the clinic. The symptoms associated with stress are general fatigue, restlessness, lack of sleep or struggle to fall asleep, anxiety, and excess worries. Apparently, the patient has to use sleep inducers and is feeling uncertain about the future after the looming divorce. The patient is currently taking Advil PM every night to sleep and drinking a glass of wine.
Smoking-related disorder (J29)
This condition occurs after prolonged smoking and might affect the general health of the patient, especially the lungs. This condition occurs after more than a decade of constant smoking and might actually affect the health of pregnancy or the child born. The condition is every worse in pregnant women since the disorder can be a contributory factor to instances such as miscarriage, early birth, and birth defects in a child (Hay et al., 2014). The patient confesses to having smoked for more than 15 years is likely to resume the trend with the current depression. Having a smoker for a long time will take a very small issue to motivate the patient to resume smoking. Unfortunately, her current stress might be the trigger since all her life has been spent around smokers.
Daughter: Jo
Diet disorder (E87)
This condition occurs when there is an imbalance in the food intake that has healthy nutrients for growth and development in children. Excessive exposure of the child to fast food, carbonated drinks, and other processed food might affect his or her health since the body will be taking more than it requires of this junk food (Hay et al., 2014). The child is at risk of developing diet-related disorders such as obesity in the long run. The patient is subjected to unregulated consumption of junk and processed food by the mother. There is a great deal of juice, soda, and processed or quick foods given in the house.
Secondary smoking disorder (09A)
This is a condition that occurs in non-smokers who are exposed to smoking by a third party and might actually develop smoking-related disorders. For instance, a pregnant who smokes daily through the period of pregnancy might affect the health of the child in the long run. Symptoms of the secondary smoking disorder include poor gum development and lung complications. Apparently, the child is exposed to the effects of secondary smoking disorder since the mother did not quit smoking when she was pregnant.
Malnutrition disorder (E78)
This is a condition that may occur in a patient as a result of an imbalance in nutrients such as iron and other multivitamins in the body. The condition is common in children who were exposed to unhealthy eating, exercising, and other behavioral habits by the expectant mother (Lozoff, Castillo, Clark, & Smith, 2012). Apparently, the patient has to depend on daily medication in the form of chewable children multivitamins with iron.
Anticipatory Guidance for Jo (5 Years Old) a Well Visit
From the above diagnosis, Jo should be subjected to further tests to check the possible exposure level to secondary effects of smoking. Besides, the patient should be enrolled for a diet course as a preventive care mechanism to minimize the potential implications of excessive exposure to fast food and carbonated drinks at a tender age. The diet plan should include her siblings since they are exposed to the same condition. In addition, iron supplements should be introduced in the form of diet by recommending moderate intake of food rich in iron (Lozoff et al., 2012). The wellness program can be rolled in the form of home-based care to give the nurse a clear picture of the environment of the child. For instance, monthly home visits can be scheduled to track the progress of the wellness program.
Education for the three patients
The education will involve self-management and lifestyle modification. The education will involve the following aspects.
- A proper nutrition plan: The diet must balance the intake of oral medication and real food. The eating plan will help in the consumption of the right quantities of protein, fluid, and salt.
- Avoiding consumption of harmful substances like alcohol and any form of tobacco.
- Regular exercise to control blood sugar levels are inevitable in the program
The objectives of this approach are sensitization of the three family members towards preventive care, provision of free checks up on a quarterly basis, and fast-tracking the results of treatment through a voluntary follow-up for treating patients as part of the cognitive therapy.
References
Hay, W., Levin, M., Deterding, R., & Abzug, M. (2014). Current diagnosis and treatment: Pediatrics (22nd ed.). Web.
Lozoff, B., Castillo, M., Clark, K., & Smith, K. (2012). Iron-fortified vs low-iron infant formula: Developmental outcome at 10 years. Archives of Pediatric and Adolescent Medicine,166(3) 208-215. Web.
Schuiling, K. &Likis, F. (2013).Women’s gynecologic health (2nd ed.). Web.