Reference no: EM133250129

Maternal Nursing Week One

Case Study

Leah is a 27 year old woman who comes to the clinic and tells the practical nurse that her menstrual period, which usually occurs on a regular basis every 28 days, is three weeks late. She thinks that she may be pregnant since she and her husband of 2 years have been trying to have a baby for 6 months.

Question 1. A pregnancy test confirms that Leah is pregnant. She asks when to expect the baby's birth. Calculate the EDD using Nagele's rule. Leah states that her last period started on June 19. When calculating an EDD, what should the PN tell the expectant mother?

Question 2. Leah tells the nurse that she works full time and asks if it would be alright if she comes for prenatal visits when she notices a problem instead of coming on a regular basis according to the set schedule. She assures the PN that she will read a lot about pregnancy in her free time and consult with her friends for advice since many of them have already had children. What should the nurse tell Leah?

Question 3. Leah calls the clinic one week after her first visit to tell the nurse that she has been feeling nauseated every morning and periodically during the day. She is especially concerned because her intake of food and fluids has decreased and she vomits once and sometimes twice a day. What should the nurse do in response to Leah's problem and concerns? What advice can the nurse give Leah? What additional information should the nurse gather?

Question 4. At Leah's second visit, she begins to ask questions about sexuality during pregnancy. She states that she and her husband enjoy each other sexually, but are now afraid that they may hurt the baby or her. How should the PN respond to Leah's concerns?

Question 5. Leah is worried that she will gain too much weight during pregnancy and not be able to lose it after the baby is born. She states "I am going to be very careful not to eat too much so that I gain only the minimum recommended, maybe even a little less." Outline what management approach the nurse should use to help Leah maintain an appropriate intake of foods and fluids throughout her pregnancy.

Question6. Leah tells the nurse that even though she is usually happy about being pregnant, sometimes she feels that she should have waited a little longer to get pregnant so that she would have more time to get ready to be a mom. She also tells the nurse that she sometimes resents the baby for making her sick and that she even gets moody and 'cries over nothing'. What approach should the nurse take in addressing Leah's concerns and expressed emotions and feelings?

Question 7. Leah's pregnancy progresses normally, and she is now in her third trimester. Leah asks the nurse if there is anything that she can do to determine if her baby is "doing okay or is having problems." How should the nurse respond?

Question 8. Why would it be helpful for Leah and her husband to begin to get things ready for the baby, including deciding about a feeding method and finding a doctor for the baby? How can you as the nurse help them with this process?

Question 9. Leah asks if she and her husband should attend childbirth classes. She states that she has been watching videos and reading books about labor, and that she and her husband have been practicing some of the recommended techniques. What should the nurse tell Leah? What information can the nurse provide?

Question 10. When Leah is 32 weeks gestation, she complains of having difficulty sleeping at night even though she is very tired. She asks if she could get a prescription for a sleeping pill. How should the nurse respond to this question? What additional information should the nurse get?