Reference no: EM133855815

Assignment:

Katherine Cordova, a 25-year-old female, gravida 4, para 2, with a history of one spontaneous abortion at 8 weeks, presents with her male partner to the community women's clinic for her first prenatal appointment. Last week, she took a urine pregnancy test at home, and it was positive. The nurse at the clinic estimates her current gestational age based on Katherine's last menstrual period at approximately 10 weeks and 2 days.

The couple has been together for 4 years; her partner is the father of her other children. Both Katherine and her partner are social drinkers, but they do not smoke cigarettes. They are weight appropriate for height, although Katherine does not engage in regular cardiovascular exercise. She estimates that she exercises perhaps twice a week for approximately 20 minutes each time. Both she and her partner work outside the home full-time; she is a teacher's aide in a second-grade elementary school class, and her partner works as a police officer. They both have health insurance, and Katherine denies financial concerns at this time. In addition, Katherine denies domestic violence, and she states that they have support of their extended family and friends. This is a planned pregnancy about which she and her partner are excited.

At this time, she reports slight nausea and vomiting in the mornings, but otherwise she is having no other symptoms of pregnancy. Her medical history is grossly noncontributory, although she has a history of genital herpes simplex virus (HSV), diagnosed at the age of 20 years. She denies recent or current outbreaks, and she is not experiencing prodromal symptoms.

Katherine is prescribed prenatal vitamins that include folic acid 400 µg daily. She is also educated on proper diet for pregnancy, which includes a diet high in grains and fiber, as well as fruits and vegetables and lean proteins. Katherine is given anticipatory guidance by the nurse practitioner in the clinic that at 36 weeks of gestation, she will need to begin suppressive therapy to help prevent HSV outbreaks during the last 4 or 5 weeks of pregnancy.

Case Analysis

This case study illustrates an example of a first prenatal care appointment for a newly diagnosed pregnancy. By beginning her prenatal care early, Katherine is helping to ensure optimal pregnancy outcomes for herself, her baby, and her family. In addition, by getting appropriate anticipatory guidance throughout the pregnancy, Katherine is able to anticipate and plan for expected changes and therapies which will be prescribed to her.

1. Why are Katherine and her partner counseled to avoid smoking and the use of alcohol?

2. How does folic acid contribute to reproductive health?