Essentials of Maternity, Newborn, and Women’s Health Nursing
Chapter 11: Maternal Adaptation During Pregnancy
1. Jessica and Mike are new clients at your obstetrics office. You are asking them about the reason for their visit. Jessica says she thinks she is pregnant because she missed a period. Mike tells you Jessica is always nauseated in the morning and eats all the time the rest of the day. They have not been using birth control and have wanted to have children since they got married last summer. Jessica says her clothes are feeling tighter and her breasts seem tender. Mike says he has noticed that Jessica has been frequently getting up to go to the bathroom at night. (Learning Objectives 2 and 4)
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a. What subjective symptoms have led Jessica and Mike to presume she is pregnant? What other conditions could be the cause of Jessica’s symptoms? How can a pregnancy be confirmed as probable? Diagnosed as positive?
The subjective symptoms include nausea, breast tenderness and amenorrhea. Jessica missed her period and eats all the time. Eating all the time could be caused by food cravings. No birth control, frequently getting up to go to the bathroom at night
A pregnancy can be confirmed as probable if there is an increased frequency of urination, increased skin pigmentation in the stomach and the face, abdominal bloating and mild uterine cramping. The proof positive signs are visualization of the fetus, positive hCG urine or blood and fetal heartbeat.
Other conditions that could be the cause of Jessica’s symptoms include diabetes, anemia, gastrointestinal disorders, malnutrition, endocrine dysfunction and menopause.
This is because the hormone hCG is present in both urine and blood.
Other conditions that could be the cause of Jessica’s symptoms are pancreatitis and anxiety disorders. The fact that she feels nauseated shows that she may be having pancreatitis. “Pancreatitis is an inflammation in your pancreas- an organ that secretes enzymes to help you digest your food” (Fairbrother et al, 2017). This may also have made her to have more foods cravings. She could be having anxiety disorders because these causes nausea. Her food cravings may have been caused by pica.
b. Discuss the nutritional needs of Jessica and her baby.
Jessica will need to consume more legumes, nuts and meat. These will provide her body with iron and proteins. The key nutrients needed by the baby include iron, vitamin A, calcium, vitamin C, D, B6 and B12. The baby will need more calcium to strengthen bones and teeth. Some of the foods that can be taken include milk and cheese. Foods such as leafy greens and carrots will provide the vitamin A while vitamin C will be provided by tomatoes, broccoli, oranges and citrus fruit. Foods such as liver and whole grain cereals will help provide vitamin B6 and B12.
Vitamin C would help promote healthy gums and bones. It would also help the body of the pregnant mother to absorb iron. Iron helps increase the blood flow to ensure that adequate oxygen is supplied to the baby. “A pregnant woman should be getting 27 milligrams of iron and 1200 milligrams of calcium” (Pick et al, 2015). These nutritional needs are met by ensuring that one eats a variety of recommended foods.
The foods she should avoid include undercooked or raw fish, high-mercury fish, raw eggs, organ meat, unpasteurized milk, cheese, caffeine and alcohol. Raw fish can cause several infections such as norovirus. Undercooked and processed meat increases the risk of infection from various parasites and bacteria such as Salmonella.
0. Beth (aged 18) is experiencing her first pregnancy and is now 24 weeks gestation. She tells you that she is “amazed by the changes that have happened to my body already.” Beth wants to understand what additional changes are going to occur to her “besides just getting a really huge belly.” Additionally, Beth relates to you that she is in her senior year of high school, is no longer involved with the baby’s father, and lives at home with her mother and 12-year-old brother. (Learning Objectives 3 and 5)
1. Explain to Beth (in terms she can understand) what general body adaptations she will experience throughout the remainder of her pregnancy.
Beth may experience swollen ankles and feet, pain in the abdomen area, leg cramps, dizziness and skin changes. “You might be experiencing pain on either one or both sides of your abdomen or hip area” (Pick et al, 2015). This is caused by the straining and stretching of the ligaments that hold the uterus. She may also experience trouble sleeping because of the huge size of the belly and have frequent heartburn.
0. What psychosocial adaptations may Beth experience as a result of being a teenage, single mother living at home?
The psychological adaptions include high stress levels, lack of financial support and emotional disorders. She may also experience pain during the delivery, fears of giving birth, social life changes and dramatic body alterations. She may also experience fears of raising the baby without the help of the father. The father would be able to provide financial and emotional support if he was available.
Pick, M. E., Edwards, M., Moreau, D., & Ryan, E. A. (2015). Assessment of diet quality in pregnant women using the Healthy Eating Index. Journal of the American Dietetic Association, 105(2), 240-246.