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Prenatal Case Study
Teresa, a 27 year-old, calls the women’s health clinic and tells her nurse practitioner that her menstrual period, which usually occurs on a regular basis every 28 days, is 3 weeks late. She thinks she may be pregnant since she and her husband of 2 years have been trying to have a baby for the last 6 months. An appointment is made to determine if Teresa is pregnant and to begin prenatal care if she is.
A. A pregnancy test confirms that Teresa is pregnant. She asks when to expect the baby’s birth. Teresa reports that her last menstrual period (LMP) began on August 11, 2018. What should the nurse explain to Teresa about her expected date of delivery (EDD)?
B. The NP prepares Teresa for her initial prenatal assessment. What components should be included as part of this assessment to ensure an adequate baseline data and to identify risk factors that may require immediate attention?
C. Since this is Teresa’s first pregnancy, she expresses concern that she and her husband do not know exactly what to expect. State the nursing diagnosis reflective of Teresa’s concern, one expected outcome, and appropriate nursing measures to use.
D. Teresa tells the nurse that she works full time and asks if it would be okay if she comes for prenatal care when she notices problems rather than coming on a regular basis according to schedule. She assures the nurse that she will read a lot about pregnancy in her free time and consult with her friends for advice since many of them have already been pregnant. What should the nurse tell Teresa?
E. Teresa call the clinic 1 week after her first visit to tell the nurse that she has been feeling nausea every morning and periodically during the day. She is especially concerned since her intake of food and fluids has decreased and she vomits about once and sometimes twice a day. What should the nurse do in response to Teresa’s problem and concerns?
F. Teresa tells the nurse that even though she is usually happy about being pregnant, sometimes she feels that she should have waited a little longer to get pregnant so that she would have more time to get ready to be a mother. She also tells the nurse that she sometimes resents the baby for making her sick and that she even gets moody and “cries at the drop of a hat.” What approach should the nurse take in addressing Teresa’s expressed emotions and feelings?
G. Teresa’s body mass index (BMI) is 23. Based on this information, what should the nurse recommend to Teresa in terms of an overall weight gain and the specific weight gain pattern for each trimester?
H. Describe the process that the nurse should use to help Teresa maintain an appropriate intake of foods and fluids during pregnancy.
Food diary
