Professional Documents
Culture Documents
A.Y.
2017-2018
Case Study
Submitted by:
Submitted to:
Mrs. Mary Grace Paayas, RN, MAN
A 34-year-old Hispanic-American woman who is in her second pregnancy and has had
one live birth and no abortions is seen for prenatal care at 24 weeks gestation. Her
weight is 220 lb, and her blood pressure is 130/80 mmHg. Uterine size is appropriate for
gestational age. The patient's past obstetric history includes the spontaneous vaginal
delivery of a 9 lb, 8 oz. male infant at 40 weeks gestation, 8 years ago in Mexico. The
patient reports that the child is doing well. Her family history reveals that her mother has
type 2 diabetes mellitus. A urine dipstick shows 3+ glycosuria and negative ketones.
Patient has a few factors that make her susceptible to the condition of Diabetes Mellitus.
The factors are her age, her ethnicity, gender, her obese weight and familynhistory from
her mother's DM type 2. With these factors, she is already prone to acquiring the
condition. It is not known she has acquired DM before or after her pregnancy. But there
are tests that can determine the confirmation of her DM. The test during diabetigenic
phase of pregnancy which is a 50 gram oral glucose loax administered between the
24th to 28th week of gestation. Gestational DM can be confirmed with this test and also
a capillary glucose reading and a fasting venous plasma glucose. A glycohemoglobin
can be done to determine if a pre-existing DM condition is and was present even before
pregnancy. Early screening is relevant to the pregnancy outcome, health and wellbeing
of both mother and infant. Patient is educated about treatment of this condition with diet
and insulin can increase intrauterine death and so, are fetal tests are also done.
QUESTIONS
1. Which of the following urinary symptoms does the pregnant woman most frequently
experience during the first trimester?
A. Dysuria
B. Frequency
C. Incontinence
D. Burning
ANSWER: B. Pressure and irritation of the bladder by the growing uterus during the first
trimester is responsible for causing urinary frequency. Dysuria, incontinence, and
burning are symptoms associated with urinary tract infections.
2. The nurse hears a mother telling a friend on the telephone about umbilical cord care.
Which of the following statements by the mother indicates effective teaching?
3. A postpartum primipara asks the nurse, When can we have sexual intercourse
again? Which of the following would be the nurses best response?
4. When performing a pelvic examination, the nurse observes a red swollen area on the
right side of the vaginal orifice. The nurse would document this as enlargement of which
of the following?
A. Clitoris
B. Parotid gland
C. Skenes gland
D. Bartholins gland
ANSWER: D. Bartholins glands are the glands on either side of the vaginal orifice. The
clitoris is female erectile tissue found in the perineal area above the urethra. The parotid
glands are open into the mouth. Skenes glands open into the posterior wall of the
female urinary meatus.
5. A patient is in labor and has just been told she has a breech presentation. The nurse
should be particularly alert for which of the following?
A. Quickening
B. Ophthalmia neonatorum
C. Pica
D. Prolapsed umbilical cord
ANSWER: D. In a breech position, because of the space between the presenting part
and the cervix, prolapse of the umbilical cord is common. Quickening is the womans
first perception of fetal movement. Ophthalmia neonatorum usually results from
maternal gonorrhea and is conjunctivitis. Pica refers to the oral intake of nonfood
substances.
SOURCES:
http://journal.diabetes.org/clinicaldiabetes/V17N31999/Pg140.htm
http://thenursingcorner.blogspot.com/2010/09/maternal-and-child-health-nursing.html