Question

Antenatal Scenario

Sara Mohammed a 37- year old female pregnant came to hospital for follow up during 35 weeks gestation age.

She is G2p1A0.

Her LMP: 11/7/2019.

She had complaints of back pain , incontinence and constipation .

Past Obstetrical History:

-1 previous NSVD (Normal spontaneous vaginal delivery

-Last birth was 3 years ago by NSVD, weighed 3200 grams

-No previous obstetrical complications or morbidity

-No Past Medical Surgical History or Family history

Social History:

Patient lives with her husband in Riyadh . Denies any smoking, alcohol or other drug use during her pregnancy. Currently works as a housewife. Good economic status.

Physical exam :

Vital Signs: Stable (BP – 120/70, P – 72)

General Appearance: No apparent distress, appeared clinically stable

Uterine Height: 35cm

Fetal Lie: Longitudinal

Presentation: Cephalic

Position: Right

Contractions: Present

Fetal Heart Tones: 144 / minute

Questions:

- Do the nursing care plan ?

NOTE: please write the answer by keyboard, not in paper.... so that the answer will be clear. Thanks❤️

Answer 1

NURSING DIAGNOSIS

Back pain, incontinence and constipation related to pregnancy

ASSESSMENT

a) Subjective data - Patient verbalise complaints of back pain, incontinence and constipation.

b) Objective data - Her facial expressions shows that she had severe discomfort

DESIRE GOAL /OUTCOME

To alleviate the back pain, incontinence and constipation  

1)Nursing intervention - Encourage the patient to take plenty of oral fluids

Rationale - Sufficient fluid is needed to keep fecal mass soft.

2)Nursing intervention - Assist the patient to take fibre containing diet

Rationale - Fibre adds bulk to the stool and makes defecation easier because it passes through the intestine essentialy unchanged

3)Nursing intervention - Assess the voiding pattern (frequency and amount) compare urine output with fluid intake. Note specific gravity.

Rationale - It identifies characteristics of bladder function (effectiveness of bladder emptying, renal function and fluid balance.)

4)Nursing intervention - Note reports of urinary frequency, urgency, burning, incontinence, nocturia and size or force of urinary stream. Palpate bladder after voiding.

Rationale - This provides information about degree of interference with elimination or indicate bladder infections. Fullness over bladder following void is indicative of inadequate emptying or retention and requires intervention.

5)Nursing Intervention - Assess and document pain characteristics

*quality_(sharp or burning)

*severity_(scale of '0' meaning no pain and '10' meaning most severe pain)

*location_(anatomical description)

*onset_(graduate or sudden)

*Duration_(continuous or intermittent)

*precipitating factors

*relieving factors

Rationale - Patient 's self report is most reliable information about the pain experience.

6)Provide comfortable position and calm and quiet environment to the patient.

Rationale - It helps the patient to relieve pain