CASE STUDY # 2 – CARE OF THE NORMAL NEWBORNPATIENT PRESENTATION:              A grandmother tells yo

CASE STUDY # 2 – CARE OF THE NORMAL NEWBORNPATIENT PRESENTATION:              A grandmother tells you, ” I always put my babies on their tummies to sleep and they did just fine. Some babies get a flat head because they sleep on their back. I don’t want that to happen to my grandson.”  How does the nurse answer the child’s grandmother? explain RATIONALE:             ALTERATIONS IN MATERNAL  PRENATAL CASE STUDY # 1 – HYPERTENSION DURING PREGNANCY Objectives:Discuss and review case study with supervisor to involve student in the decision making realities of the home care setting.Case study is to be used as a basis for conference with supervisor and /or peer group. PATIENT PRESENTATION: Peggy pregnant is a 38 year-old female who will be having a prenatal at the Rural Health Unit. She is 25 weeks pregnant. This is her first pregnancy. She has some complaints of mild intermittent headaches, fatigue and some lower extremity swelling and has had one episode of elevated blood pressure of 140/90. HISTORY:            Mrs. Pregnant has been married for eight years and this is her first pregnancy. She attended two years of college and works full time as a hair dresser so she is on her feet most of the day. She has been active in her community and church. She also volunteers . She runs 3 miles per day.            Mrs. Pregnant’s parents are alive and in fair health. Her mother has hypertension and hyperlipidemia both of which she takes medication for. Her father also has a history of elevated blood pressure ; however, he is well controlled by lifestyle changes (dietary changes, exercise and weight loss.) her maternal grandfather died from complications of heart disease at an early age.            Mrs. Pregnant reports having the “normal” childhood illness of chickenpox. She does have a documented pre-hypertension prior to her pregnancy. She denies any other complications or prolonged illnesses or injuries.REVIEW:What are Mrs. Pregnant’s risk factors?What are her strengths?What would you include in your objective assessment?What would you include in your review of systems?What will you include in your physical assessment?What will you include in your psycho-social assessment?What and when would you check in with her provider?What anticipatory guidance would you include in your visit?What plan of care would propose to Mrs. Pregnant and her provider for further home care involvement? PRENATAL CASE STUDY # 2 – TOBACCO ABUSE AND PSYCHO-SOCIAL RISKSOBJECTIVES:Discuss and review case study with supervisor to involve student in the decision making realities of the home care setting.Case study is to be used as a basis for conference with supervisor and/or peer group. PATIENT PRESENTATION:Cindy Sue is a 19 year  – old female client who will be having prenatal home care at the request of her OB/GYN. Mr. Sue is 15 weeks pregnant. This is her second pregnancy. To date she has had a slow weight gain and mild exacerbation of her asthma.HISTORY:            Mr. Sue is a single mother. She has a two year old son at home. She has a high school diploma. She is not working. The father of her son is not involved nor is the father of the baby. She does not have a great support network in place. Ms. Sue is a 1 pack per day smoker and has a poor diet. She drinks several cups of coffee and cola per day. She sleeps an average of 4-5 hours per night. Her stress level is high as result of financial struggles and simple parenting.            Ms. Sue had a turbulent childhood which left her with a history of post-traumatic stress disorder. She takes anti – depressant medication daily which helps her control her depression after the birth of her first child. She is not in counselling. She also has a history of asthma. She denies any other complications or prolonged illnesses or injuries. She denies any alcohol or illicit drug use.REVIEW:What are Ms. Sue’s risk factors (physical & psychological)?What are her streghts:What would you include in your objective assessment?What would you include in your review of systems?What will you include in your physical assessment?What will you include in your psycho-social assessment?What and when would you check in with her provider?What anticipatory guidance would you include in your visit?What community resources would you prefer Ms. Sue to?How would you assess Ms. Sue’s readiness for change around her smoking cessation and how would you proceed with information you gained from that assessment?What plan of care would you propose to Ms. Sue and her provided for further home care involvement? PRENATAL CASE STUDY # 3 – POSTPARTUM MATERNAL COMPLICATIONSPATIENT PRESENTATION:            Dolores Navarra , a 28 year-old Gravida 4. Para 3 has a rapid labor and delivers a baby boy weighing 4000 g (8 lb./12 0z.) Two hours later, she is transferred to postpartum. At the initial postpartum assessment, Dolores fundus is firm at the level of the umbilicus. Lochia is heavy, with occasional small clots expressed. V/S are unchanged from prenatal works. The nurse observes that the fundus is soft and lochia is excessive. Within an hour, the fundus becomes “Boggy” again and is located 3 cm. above the umbilicus and displaced to the right. QUESTION:What are the priority nursing interventions? Why? explain RATIONALE:              CASE STUDY # 1 – HIGH – RISK NEWBORN: AQUIRED AND CONGENITAL CONDITIONSPATIENT PRESENTATION:            Holly, a 3 day old full term infant born by caesarean, is jaundiced secondary to ABO incompatibility and receiving phototherapy. She weighs 3.2 kg (7lb., 1 oz.) and her mucous membranes appear slightly dry. Skin turgor is good with quick recoil, and the anterior fontanel is flat. Urine appears slightly dark in color. Holly had 3 loose green stools with no water ring on this shift. She is a sleepy infant who takes formula poorly. Valerie, her mother appears tired and frustrated with the infant’s slow eating behavior. QUESTION:Why is it important to remove the patches from the eyes each time the infant is taken from phototherapy for feeding or when parents visits? explain rationale Health Science Science Nursing NURS 601 Share QuestionEmailCopy link Comments (0)

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