OB Case Study Week 1
NURS 4434 Care of Childbearing Family
Antepartum Care Situation
Learning Objectives: After careful reading of narrative and supporting data student will construct an Antepartum Care Worksheet
1. Interpret provided blood test results; Pre-shift report, Reason for hospitalization; Discussion of medical diagnosis; discussion of obstetric and pregnancy history; Fetal monitoring; and Maternal vital signs.
2. Discuss family configuration; cultural/spiritual assessment, and financial/emotional health.
3. Prioritize Problem List/Nursing Diagnosis, R/T and AEB — three for mom and three for baby.
4. Review and record medications including drug name, dose, side effects (look-up) on Scheduled Medication Worksheet.
5. Compose detailed Care Plan for mother including: Highest Priority Nursing DX; Plan; Intervention; Rationale; Assessment; Skills Used; Legal Ethical Issues; and Safety Concerns
6. Compose detailed Care Plan for infant including: Highest Priority Nursing DX; Plan; Intervention; Rationale; Assessment; Skills Used; Legal Ethical Issues; and Safety Concerns
7. Present Nursing Skills; Your Strengths; What Opportunities for improvement there may have presented to you in this situation.
CASE STUDY
After meeting with course instructor at 0630 on 3/16/20 you proceed to meet the charge nurse who then assigns you Tarka RN. Nurse Tarka takes you to room 564 to meet client Maria Garcia.
Mary Garcia is 34-year-old married woman with one child (a son) that is thee years old. This was a vaginal delivery. She is pregnant with second baby and thinks she is 34 weeks pregnant. She weighs 220 pounds. Patient has scant prenatal care. Her husband brought her in last night because she was dizzy with blurred vision. She states that she “has no pain at this time.” Her temperature 98.8, blood pressure was 150/81, her respirations 34. The patient’s last postprandial glucose test was 193 mg/dl. Patient’s fasting glucose was 149 mg/dl. Her blood pressure was 143/85, respiration 28, and temperature 98.8
She is concerned that “she has to go home to take care of her three-year-old son because her husband has to go to work” and her mother (who lives with her) is out of town.
Fetal heart monitoring was reassuring, but ultrasound indicated that the baby may be large for gestational age.
Patient states that “her baby seems to be moving less” and she is afraid that her baby may come early.
Test results
Blood type A+ Rubella Immune
Rh factor Positive HIV negative
Antibody screen negative RPR/VDRL Negative
Hgb 12.7 HbSAg Negative
Hct 35.5 Gonorrhea negative
WBCs 6.5 Chlamydia Negative
Platelets 204 GBS negative
New doctor’s order: Pt. put on a calorie restrictive diet and pre and postprandial blood sugar test. Pt. to monitor her blood pressure. Pt. is instructed to monitor fetal movement. Mary has orders to see her obstetrician next week.
Complete assessment of mother and baby (cite sources).
Care plan for mother and baby.
Prioritize Nursing diagnosis (including R/T and AEB) 3 for both mother and baby.
Cite where you got this information.
