Maternal Child Nursing Case Study Assignment
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Patient History
S.W is a 16-year-old girl. From the records, little is known about her medical background before the onset of her pregnancy which means that little is known about any underlying conditions which may be important in predicting any pregnancy complications. S.W is a member of the First American community and is 36 weeks pregnant, meaning that she is about four weeks from delivering the baby. From her age, and the fact that she has to be accompanied for prenatal visits, during which she is always quiet and evades eye contact, it can be inferred that this is S.W’s first pregnancy. S.W’s pregnancy has been relatively normal. She has gained 23 pounds during her pregnancy and which the prenatal health specialists considered to be normal which implies that she had a BMI of between 25.0-29.9. This shows that she was overweight for a 16 year-old-girl before the onset of her pregnancy. 16-year-olds of normal weight have a BMI of between 17 and 24. The laboratory tests showed no peculiarities and her blood pressure was normal during her previous prenatal visits. S.W had an ultrasound 16 weeks ago and there were no indications of fetal abnormalities. On this day, S.W has arrived with her family and the mood is more serious indicating a problem with the pregnancy.
Present Plan of Care and Future Recommendations
The present care plan has involved talking to the members of the family that accompany S.W and asking her about her condition because S.W herself is timid during her prenatal visits. The midwife begins S.W’s medical history at the point when she attends her first prenatal care and most of the plan of care has involved assessing S.W’s labs, blood pressure and conducting occasional ultrasounds to assess the fetus’ condition.
This plan of care is significantly dangerous particularly for a girl as young as S.W who is condition makes her vulnerable to a pregnancy complication (Hanson, 2012). Pregnant teenagers have developmental needs, physical care needs, and educational needs which should be addressed in an ideal care plan (Montgomery, 2003). The midwife should have ensured that S.W is comfortable in expressing herself the minute she walked into her premises for her first visit. Because teenagers are at high risk for pregnancy complications, they should receive regular tests for blood pressure, weight gain, and height. Their dietary practices should also be assessed. Furthermore, teenagers should also be provided with educational support at various stages of the pregnancy with a focus on their most immediate needs.
Nursing Intervention
The nursing intervention will be anchored on the five-step framework of assessment, diagnosis, outcomes, implementation, and evaluation for a comprehensive intervention program. A proper nursing intervention would involve a combination of physical, educational, and emotional intervention (Montgomery, 2003). The nurse should thus make S.W feel comfortable enough to talk and find out the teenager’s medical history. In this way, the nurse can learn the physical or emotional reasons for her current condition. This is a crucial part of the assessment stage as it can reveal emotional distress, domestic violence, substance abuse, and other realities which will need special interventions (Montgomery, 2003). The nurse then performs a diagnosis by sending blood and urine for testing, monitoring the patient’s blood pressure of both the mother and the fetus, and conducting other diagnostic measures that could indicate a pregnancy complication. Once the diagnosis is complete the nurse should assess the results of the diagnosis and implement the right intervention for the teenager. If the teenager is suffering from a physical affliction, the nurse should ensure that the teenager has received the appropriate medical care. The nurse also has a significant role in providing educational and emotional support for the teenager and the mother. The nurse should advise the teenager and the mother to increase the frequency of their prenatal visits since complications such as preeclampsia tend to emerge during this stage for young mothers. Additionally, the nurse should ensure that the mother and the pregnant teenager have received help in case of issues such as domestic violence and other forms of abuse. The nurse also has to ensure that the pregnant teenager and the mother receive nutritional advice.
Primary and Secondary Diagnoses
From the case study, the primary diagnosis is a case of an emergent pregnancy complication such as preeclampsia which emerges during this stage of the pregnancy among pregnant teenagers (Cavazos-Rehg, 2015). Pregnant teenagers with attributes similar to S.W are particularly at risk for this complication. The secondary diagnosis is emotional or psychological trauma as evidenced by S.W’s timidity when she visits the hospital. Pregnant teenagers are vulnerable to emotional and psychological stressors because of their condition and hence they are more likely to develop mental health and emotional problems.
Conclusion and Recommendations
S.W is an example of the plight of pregnant teenagers from marginalized. The below quality care she receives at the community midwife’s facility exposes her to physical and emotional vulnerabilities which could affect her health and that of the fetus. A proper nursing intervention involves taking care of the physical, emotional, and educational needs of the pregnant teenager in order to provide comprehensive care. Nursing practitioners should be keen on such at-risk teenagers who are exposed to danger because of the intersectionality of their physical state and the social factors that affect them. Health officials should find ways of educating and equipping informal health practitioners who deal with such marginalized persons on the best intervention methods for pregnant teenagers who are almost always in a precarious condition.
References
Cavazos-Rehg, P. A., Krauss, M. J., Spitznagel, E. L., Bommarito, K., Madden, T., Olsen, M. A., … & Bierut, L. J. (2015). Maternal age and risk of labor and delivery complications. Maternal and child health journal, 19(6), 1202-1211.
Hanson, J. D. (2012). Understanding prenatal health care for American Indian women in a Northern Plains tribe. Journal of Transcultural Nursing, 23(1), 29-37.
Montgomery, K. S. (2003). Nursing care for pregnant adolescents. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 32(2), 249-257.
