Reference no: EM133636016
Case on Chronic Illness (Pregnancy & GDM)
Ms. H, a 30-year-old-woman, a dedicated elementary school teacher, received a diagnosis of GDM at 26 weeks gestation (2nd trimester), prompting immediate intervention and lifestyle modifications to manage her blood sugar levels.
Medical History: Stress-induced due to her high demand job; and insomnia while studying in university.
Allergies: Sulphite
Admission to ED: Oct 2, 2023, with elevated blood sugar levels
Vital Signs: T= 37.10C P= 75 R = 16 BP = 110/74 mmHg
Oxygen saturation on room air - 95%
Medications: Folic Acid 0.4 mg (400 mcg) one tab PO OD. Tylenol 325 mg 1 -2 tabs PO PRN for headache
Lab: CBC and electrolytes; urine for C + S and electrolytes
Consult Order: OB for her pregnancy (26 weeks pregnant)
She was experiencing morning sickness and unable to tolerate any food by mouth. Ms. H. enrolled in a prenatal class with specific interest in consulting a registered dietitian.
Ms. H's obstetrician collaborated with a certified diabetes educator and nutritionist to develop a comprehensive care plan tailored to her specific medical and dietary needs. Her OB has stressed the importance of balancing her dietary considerations, regular physical activity, and close medical monitoring posed significant adjustments to her daily routine and emotional well-being.
Ms. H grappled with the challenges of dietary restrictions and the need for frequent glucose monitoring while ensuring a healthy and stable environment for the growth and development of her unborn child. She hates to check her blood sugar levels as she dislikes needles. Often times she is non-compliant in checking as she often feels lightheaded.
Ms. H is experiencing a heightened level of anxiety and emotional distress due to the fear of potential complications such as macrosomia and increased risk of cesarian delivery . The constant vigilance required to maintain stable blood sugar levels created a sense of emotional upheaval, often contributing to feelings of frustration and self-blame. Additionally, the perceived limitations on her dietary choices and the impact on her social interactions created a sense of isolation and affected Ms. H's overall well-being.
She has felt ambivalent towards the pregnancy as this was unplanned. Her boyfriend whom she has been with for 3 years is not very supportive of the pregnancy and becoming a father.
CARE PLAN ASSIGNMENTS: Outline and Grading Rubric
Use the nursing process (ADPIE) to identify the following from the information provided in the case study.
Assessment: Assessment Data for the patient
Complete the Patient Demographic Form
Actual and potential problems: Review the assessment data collected. From this information identify and create a list of areas of concern/symptoms for your client. (Actual and Potential problems)
Clustering and prioritizing your data: From the list you created - group similar data that pertain to the identified areas of concern/symptoms. These groupings will help you to identify the actual and potential health problems for your client. Keep in mind class content.
List of priorities: Prioritize the grouping of data collected from the highest to the lowest order of priority.
Diagnosis & Analysis: What is the priority problem being experienced by the patient? This is your diagnosis.
Planning: How and When does this need to be fixed? What are the priorities?
Intervention: What nursing interventions both pharmacological and non-pharmacological can you use to support this patient's care needs that DIRECTLY will impact the priority problem? How do you know this is an important intervention? Provide your rationale with APA reference.
Evaluation: This is your outcome! What do you expect will happen after the intervention is implemented? What is the timeline that it should be completed within?
Your care plan must include: (Refer to NCP Template to complete)
Diagnosis - choose ONE that pertains to the client
Two (2) goals related to the above diagnosis - SMART format
For EACH goal you are required to have 4 interventions with 4 rationales: one related to social determinants of health the other anatomical/physiological.
Goal #1 - must have 4 interventions with rationale
Goal #2 - must have 4 interventions with rationale
Each intervention needs an outcome statement please ensure you include a TIMELINE.
Each rationale must be supported by current scholarly resources within the last 5 years.