Antepartum Case Study

P.M. comes to the obstetric (OB) clinic because she has missed 2 menstrual periods and thinks she may be pregnant. She states she is nauseated, especially in the AM, so she completed a home pregnancy test and it was positive. As the intake nurse in the clinic, you are responsible for gathering information before she sees the physician.

1. What are the two most important questions to ask to determine possible pregnancy?

2. She tells you she has never been pregnant. How would you record this information?

3. What additional information would be needed to complete the TPAL record?

4. It is important to complete the intake interview. What categories should you address with P.M.? CASE STUDY PROGRESS According to the clinic protocol, you obtain the following for her prenatal record: CBC, blood type, urine for urinalysis (UA) (protein, glucose, blood), vital signs (VS), height, and weight. Next, the physician or nurse-midwife does a physical examination, including a pelvic exam, and confi rms P.M. is pregnant, the fetus is at approximately 6 weeks’ gestation, and she has a gynecoid pelvis by measurement.

5. How would you calculate her due date?

CASE STUDY PROGRESS

Pregnancy is divided into 3 trimesters, each lasting about 3 months. Nursing interventions focus on monitoring the women and fetus for growth and development; detecting potential complications; and teaching P.M. about nutrition, how to deal with common discomforts of pregnancy, and activities of self-care. 6. A psychologic assessment is done to determine P.M.’s feelings and attitudes regarding her pregnancy. How do attitudes, beliefs, and feelings affect pregnancy?

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