What Should the Nurse Do?
Lara, a 32-year-old female eagerly anticipating motherhood, arrives at the obstetrics clinic at St. Mary’s Hospital for a routine prenatal checkup in the second trimester. While her medical history reveals a healthy lifestyle with no underlying medical conditions, Lara expresses an array of pregnancy-related symptoms that have been causing her some unease. She reports experiencing mild but persistent nausea, especially in the morning, along with a lingering sense of fatigue that tends to intensify as the day progresses. As she navigates through the profound changes in her body, Lara finds herself grappling with heightened levels of anxiety. Her anxiety manifests as a preoccupation with the physiological transformations she is undergoing, prompting her to seek a better understanding of the intricate processes at play during pregnancy.
1
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Lara is experiencing mild but persistent nausea and increased fatigue. Explain how the physiological changes during pregnancy, particularly hormonal influences, contribute to these symptoms.
2
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Lara is curious about the role of placenta hormones in supporting her pregnancy. Describe the functions of hCG, hPL, and estrogen during pregnancy.
3
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Lara is seeking assurance regarding the signs of her pregnancy. Explain the differences between presumptive, probable, and positive signs of pregnancy and provide examples relevant to her situation.
Georgia, a 28-year-old pregnant female, arrives at the obstetrics clinic in Mercy General Hospital for her scheduled prenatal appointment, now well into her third trimester. As she engages with her healthcare provider, Georgia shares a more detailed account of the emotional journey she has been navigating during this pregnancy. Alongside the anticipated excitement of impending motherhood, Georgia reveals that she experiences occasional episodes of heightened anxiety, often triggered by the uncertainty and rapid changes accompanying this transformative period. These moments of unease are further compounded by noticeable mood swings, a rollercoaster of emotions that she acknowledges may be influenced by hormonal fluctuations and the broader emotional weight of impending parenthood. Despite these challenges, Georgia is keen to emphasize that she has a robust support system in place, including her partner, siblings, and extended family. She describes her partner as actively involved and supportive yet navigating their own set of adjustments during this journey.
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Georgia experiences occasional episodes of heightened anxiety and noticeable mood swings. How might these emotional challenges impact her psychosocial adaptation to pregnancy, and what nursing interventions can support her during this transformative period?
5
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Georgia mentions that her partner has experienced phases of increased and decreased interest in the pregnancy. Explain how the partner’s adaptation to pregnancy may influence the overall support system. What strategies can the nurse suggest to enhance the partner’s engagement throughout the pregnancy?
6
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If Georgia has other children, how might the age of the child influence their adaptation to the pregnancy and impending birth? What steps can the nurse recommend to promote positive sibling adaptation and prevent potential challenges?
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Georgia emphasizes having a robust support system, including extended family. How can the extended family members prepare for the changes accompanying the newborn’s arrival? What role can the nurse play in assisting and educating the extended family to support the pregnant person?
Jennifer, a 34-year-old female in her second trimester of pregnancy, arrives at the obstetrics clinic for her scheduled prenatal checkup. In a detailed conversation with her healthcare provider, Jennifer elaborates on the common discomforts she has been encountering during this pregnancy. She describes persistent lower back pain that intensifies after prolonged periods of standing or sitting. Additionally, Jennifer mentions experiencing occasional leg cramps, particularly at night, disrupting her sleep and contributing to an overall sense of fatigue during the day. As she recounts her experiences, Jennifer expresses frustration with the difficulty she encounters while trying to find a comfortable sleeping position, often disrupted by a combination of back pain and restless legs.
8
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Based on Jennifer’s symptoms, which common discomforts of pregnancy is she currently experiencing, and what are the possible physiological or anatomical causes for each symptom?
9
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What nonpharmacological relief measures can be suggested to Jennifer for her lower back pain, leg cramps, and difficulty sleeping, based on the information provided in the chapter?
10
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How can nurses promote self-care practices related to hygiene during pregnancy, specifically addressing Jennifer’s concerns, and why is perineal cleansing important?
11
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What self-care practices can Jennifer adopt to prevent constipation, and why is prevention important during pregnancy, based on the information provided?