1. A 35-year-old G1P0 patient, at 20 weeks gestation, with a history of hypertension presents with elevated blood pressure and symptoms of light-headedness and palpitations. As the nurse, the following actions should be taken:
– Perform a thorough assessment, including vital signs, fetal heart rate monitoring, and a review of her medical history.
– Notify the healthcare provider immediately about the elevated blood pressure and symptoms.
– Monitor the patient closely for any signs of worsening hypertension, such as severe headache, visual changes, or epigastric pain.
– Consider initiating antihypertensive medication if blood pressure remains elevated and symptoms persist.
– Educate the patient about the importance of regular prenatal visits, adherence to prescribed medications, and lifestyle modifications to manage hypertension during pregnancy.
– Collaborate with the healthcare team to develop a care plan that includes regular blood pressure monitoring, fetal growth assessment, and close follow-up.
The patient should be encouraged to make the following changes:
– Follow up regularly with her healthcare provider to monitor blood pressure and fetal well-being.
– Take any prescribed antihypertensive medication as directed.
– Maintain a healthy lifestyle by following a balanced diet, engaging in regular physical activity, and avoiding smoking or excessive alcohol consumption.
– Monitor her blood pressure at home, as instructed by her healthcare provider.
– Report any concerning symptoms or changes in fetal movement to her healthcare provider immediately.
The expected outcomes for this patient include:
– Stabilization of blood pressure within the target range.
– Improvement in symptoms of light-headedness and palpitations.
– Normal fetal growth and well-being.
– Prevention of complications associated with hypertension during pregnancy, such as preeclampsia or fetal growth restriction.
– A healthy pregnancy and delivery.
2. A 17-year-old patient arrives at the emergency department in active labor with an uncertain obstetrical history, no prenatal care, and Rh-negative blood type. As the nurse, some concerns to be prepared for include:
– Limited knowledge about the patient’s background and obstetrical history, which could affect the management of labor and delivery.
– Potential risks associated with inadequate prenatal care, such as undiagnosed medical conditions or infections.
– The need for Rhogam administration due to the patient’s Rh negative blood type.
– Uncertainty regarding the patient’s understanding of the labor process and lack of preparation for childbirth.
– Psychosocial and emotional factors related to the patient’s age and potential lack of support or resources.
The patient requires teaching in the following areas:
– Explanation of the labor process, including stages of labor, pain management options, and expectations during delivery.
– Education regarding the importance of prenatal care, regular check-ups, and potential risks associated with inadequate care.
– Discussion about the benefits of Rhogam administration and the implications of Rh incompatibility for future pregnancies.
– Reinforcement of contraception options to prevent unintended pregnancies in the future.
– Referral to appropriate resources for social support, financial assistance, and ongoing healthcare.
The expected outcomes for this patient include:
– Safe delivery with minimal complications for both the mother and baby.
– Adequate postpartum follow-up to address any unresolved concerns or issues.
– Referral to appropriate community resources for ongoing support and healthcare needs.
– Increased knowledge and understanding of the importance of prenatal care and contraception.
– Improved awareness and engagement in self-care and healthy lifestyle choices.
3. A 15-year-old female presents to urgent care with complaints of nausea, vomiting, fatigue, and a missed period. As the nurse, the following nursing care should be provided if she is indeed pregnant:
– Perform a pregnancy test or coordinate a laboratory test to confirm the pregnancy.
– Provide emotional support and a non-judgmental environment for the patient to express her concerns and feelings.
– Assess the patient’s understanding of pregnancy and available resources.
– Educate the patient about prenatal care and the importance of seeking early and regular prenatal visits.
– Provide information on healthy practices during pregnancy, such as nutrition, exercise, and avoiding harmful substances.
– Assess the patient’s social support system and refer to appropriate resources if needed.
– Discuss potential options and resources for pregnancy and childbirth preparation, including childbirth education classes.
– Collaborate with the healthcare team to create a care plan tailored to the patient’s specific needs and circumstances.
The nursing diagnoses that may apply to this situation include:
– Risk for inadequate prenatal care related to late recognition of pregnancy and lack of knowledge.
– Fatigue related to pregnancy and possible complications.
– Nausea and vomiting related to pregnancy or other causes.
– Anxiety related to a potential unplanned pregnancy and its implications.
Some expected outcomes for this patient include:
– Early and regular prenatal care engagement.
– Reduced symptoms of nausea, vomiting, and fatigue.
– Improved understanding of prenatal care, healthy practices, and available resources.
– Development of a support network or involvement of appropriate support resources.
– Informed decision-making concerning the patient’s pregnancy options.