Reference no: EM132462226 , Length: 4 pages

Assignment: Case study

Directions

Part 1. Review the information regarding pregnancy assessment and complications in pregnancy in the textbook.

Part 2. Read the following case study and reply to the questions.

Referenced using APA 6th edition.

Case Study

Dylan is a 36 year old female who has come for a routine 28 week prenatal check-up. She is a non-smoker, is physically active and has gained 4 kg of weight so far in her pregnancy. Dylan'sobstetrical history is G2 T0 P0 A1 L0. Both pregnancies have been assisted with in-vitro fertilization. During this first trimester, Dylan has suffered from nausea and vomiting but it has now resolved. Now, Dylanstates she is exhausted all the time. The fetus is active and Dylan has been keeping track of movement by daily kick counts. Dylan's blood pressure has been stable throughout the pregnancy.

You are the clinic nurse for the day and are caring for Dylan during her prenatal appointment.

Question 1. What are your six priority assessments?
You step out of the room for a minute to assess Dylan's urine.

Question 2. Name fourabnormal urine findings during pregnancy. What is the significance ofeach of these findings?
You have Dylan lay down to measure fundal height. The measurement you obtain is 29cm.

Question 3. Explain how a fundal height is measuredand if the finding of 29 cm is normal or abnormal for this point in Dylan's pregnancy

Question 4. What diagnostic tests would you anticipate the primary care provider ordering if there were an abnormal fundal height?
The next step in your prenatal check is to auscultate the fetal heart rate.

Question 5. Describe the steps to take when assessing the fetal heart rate.

You listen for one minute and find that the fetal heart rate is 130bpm with regular rhythm and no decelerations heard.

Question 6. Discuss the significance of these findings.

Outside the exam room, you provide a report to the primary care provider of all assessment findings and mention that Dylan states she feels exhausted all of the time.The primary care providergoes into assess the patient. Dylan restates the constant feeling of exhaustion and the primary care provider orders a complete blood countto be done prior to the next visit.

Question 7. Why do you think the physician is ordering a complete blood count?

Two weeks later, Dylan returns for a follow-up prenatal visit. Dylan states that the fetus is moving, but the exhaustion remains, and she has now started to feel dizzy occasionally and finds it is hard to catch her breath. Dylan's blood work results are on file and show the following:

• RBC - 3.0x10¹²/L
• WBC - 7 x 10⁹/L
• Hct - 0.30
• Hgb - 109 g/L

Question 8. What are fivepotential impacts to the pregnancy and fetus if these values are not corrected?

Question 9. What medication would you anticipate the primary care provider to order based on the above lab results? Provide your rationale.

Question 10. What fiveteachingpoints would you provide around this medication and her condition?

The rest of Dylan's prenatal check-up is unremarkable and she is about to leave with her prescription.

Question 11. List four priority teachings you would provide at the end of this appointment.

Attachment:- Maternity Case study - caring for Dylan.rar