BSN 2 / NCM 109

MAKE A NURSING CARE PLAN AND PRESENT IT TO THE GROUP.

CASE STUDY:
Mrs. K. is a 32-year-old Asian woman who is married and is 4 weeks
pregnant. This is her first pregnancy and just had her first visit with her physician.
During her visit, Mrs. K. stated that she was nauseated and vomited frequently
throughout the day. The obstetrics/gynecology (OB/GYN) assumed it was morning
sickness and orders Phenergan to help control the nausea and vomiting. He tells
Mrs. K. to make a follow-up appointment if the condition worsens.
Two weeks later Mrs. K. sees the OB/GYN physician and states that her
nausea and vomiting is now severe. She states that she is unable to go to work or
do any normal daily activities. The OB/GYN upon examination of Mrs. K. finds the
following: Mrs. K. has lost 5 pounds in the last 2 weeks and shows signs of
significant dehydration.
Signs and symptoms include pallor, increased ketones in the urine,
increased urine specific gravity, abnormal sodium and potassium levels, dry
tongue, low blood pressure of 88/60 mm Hg, dizziness requiring a wheel chair
from the car to the office, and extreme weakness resulting in inability to ambulate
without assistance.
She has a limited social support system since she just moved from another
city. Mrs. K. tells the physician that her husband works 50 to 60 hours a week and
is unable to care for her on a regular basis. The physician asked Mrs. K. if her
mother suffered from severe vomiting and nausea during her pregnancy and Mrs.
K. stated yes.
After his examination, the physician recommended continuous intravenous
therapy with vitamins and thiamine. In addition, he prescribed ondansetron
(Zofran) as the medication of choice to decrease nausea and vomiting. Home
healthcare visits by nurses were approved and are to begin immediately.