NCMA 217

Case Study
CARE OF MOTHER, CHILD AND
ADOLESENCE (WELL-CLIENT)
 Members
Framework for Maceda, Russel
Maramag, Mariah Niña

MATERNAL AND Maycacayan, Angeline

Mayola, Hezel Jane

CHILD HEALTH Mendoza, Angela

Pagba, Kiara Therese

NURSING Rabanal, Marcus Breis

Valdez, Ashley
BSN 2 A-6 Velasco, Alfonso Louise
Vidanes, Kaila Nicole
Zapanta, Via Kristel
 Case Scenario
Ms. Chin Won, age 26, presents
at the community health center
in her initial prenatal care visit.
She is found to have an
elevated blood pressure and
excessive swelling in her legs
and feet. The fetus appears
small on a sonogram.
 QUESTION#1
1. WHAT ARE SOME REASONS THAT EARLY
PRENATAL CARE MIGHT HAVE HELPED TO
DECREASE CHIN WON'S RISK FOR MATERNAL
MORTALITY AND PERINATAL MORTALITY?

By getting an early prenatal care, it can help Ms. Won and her
baby to stay healthy. Any abnormal changes in her pregnancy
will be monitored and she can avoid complications. Doctors
can also keep a close eye on her blood pressure and blood
sugar levels since pregnant women occasionally develop
gestational diabetes, which can induce pre-eclampsia and
result in high blood pressure and blood sugar.

QUESTION#2 Make sure that Mrs. Won and her family know about
the service before they arrive and what to expect and
bring.
Considers the family as a whole and as a partner in
care when planning or implementing or evaluating the

What measures might the

effectiveness of care.

nurse take to ensure that

Chin Won's care is family Respecting the family and patient’s confidentiality.
Encourage family bonding through rooming-in and

centered? family visiting in maternal and child healthcare

settings.

Providing guidance and monitor the interaction
between family members to promote the health
and well-being of the family unit.

Creating a safe environment for the family and

patient to be able to ask questions.
 Cultural assessment will help Ms. Chin Won and
the nurse in creating a treatment plan that will
be mutually beneficial and culturally appropriate.
A cultural assessment may be beneficial when
planning because her cultural background might
influence her demands and preferences during
pregnancy and puerperium. One of how cultural
assessment may impact the plan of care is
through the assessment of the client’s religion.

QUESTION#3
How might cultural
Some religions provide dietary restrictions and guidelines in
order to express their faith. In this way, the nurse should

assessment be beneficial
respect and modify the client’s daily diet since this is an
important component of culturally sensitive nursing care.
Moreover, people of different cultures have different
beliefs regarding vitamins and medicines. In these
circumstances, the nurse can explain the implications of not when planning with Chin
taking their prescription and suggest beneficial ways
vitamins can contribute to the maintenance of her health Won for health restoration
and maintenance
during pregnancy and puerperium. In conclusion, Ms. Chin
Won has the right to have their cultural beliefs, values, and
practices understood, respected and considered in making a
plan for health restoration and maintenance in a culturally
competent way. If the nurse is aware of Ms. Chin Won's
throughout the pregnancy
level of cultural integrity, he or she will be able to begin
negotiating with her. Effective communication, and puerperium?
understanding of her beliefs, and respect will help her and
her family achieve health care goals throughout her
pregnancy and puerperium

QUESTION#4
How would the plan of care
look if Chin Won were a
single woman, a working
mother, or a teen?

 BUILD A SUPPORT SYSTEM FOR THE CLIENT

QUESTION#4
2
single woman
AND INCLUDE HER IN DECISIONS ABOUT HER
HEALTH
The patient should build a support
system with family and friends and the
healthcare professionals who will treat
her during pregnancy. It will provide
emotional support, let her voice her
decisions or fears about her situation,
and ensure her well-being before giving
birth.

1 ENSURE PRENATAL CARE VISITS

ARE SCHEDULED REGULARLY.
It is important part of a
pregnant woman's health.
Visiting prenatal care will help
PLAN TO MAINTAIN HEALTHY DIET
3
prevent and treat the problems
that can arise during pregnancy,
Eating healthy foods, such as fruits
control your blood pressure,
and vegetables, will help you to be
and check on you and your
healthy during your pregnancy. Talking
growing baby at each visit. It
with your dietitian can also help you
will also help you take the right
avoid high-sodium foods that may
medications to ensure you are
raise your blood pressure.
healthy.
 QUESTION#4
WORKING MOTHER
1
RECOMMEND CONTINUATION OF
PRESCRIBED TREATMENTS AND 2PROMOTE HEALTHY DIET
Maintaining healthy diet can
EXERCISE balance your body to get more
nutrients needed, it is
Proper treatments such as
medication and prenatal care can recommended that pregnant
prevent complications. Through the mothers need to acknowledge
guidance of the doctor, healthy diet that includes
physiotherapist, or health care
professional, regular exercise can High in Nutrients
benefit both mother and child by Prenatal Vitamin Supplements
increasing the ability to cope with
the physical demands of
motherhood.
 QUESTION#4
WORKING MOTHER
3 ENCOURAGE TO PROMOTE SELF-CARE
Self-care may help the mother to
4 ADVICE TO MAINTAIN PROPER REST
Working mothers, while pregnant,
effectively alleviate the stress that should be advised to limit their
can cause further concerns after workloads and rest as much as
giving birth, such as, postpartum possible. These measures will help
depression, postpartum hemorrhage, ensure the health of both mother
and infection. This can help to
and baby. The client may
promote good outcomes especially
when you are a working mother, who experience pregnancy risk and
needs to maintain a sense of self- complications before working,
worth. which can increase psychological
and physiological stress due to
workload given.
 QUESTION#4
Teenage pregnancy care

1 ENSURE THE CLIENT IS RECEIVING

THE SUPPORT NEEDED
2ENCOURAGE HEALTHY PREGNANCY
Being pregnant as a teenager
puts you at higher risk for
Teen parents are more likely to having a baby born too early,
experience school dropout, with a low birth weight and,
unemployment, poverty, mental tragically, higher risk of death.
health problems, and child care If a pregnancy is unplanned, the
concerns. Ensuring that adolescent mother may not be getting the
parents receive adequate social, prenatal care she and her baby
emotional support, medical care, and
need or may not even be
academic support is essential to the
healthy enough to carry a child
parent and the baby’s future.
to term.
 QUESTION#4
Teenage pregnancy care
3
SUGGEST/OFFER ATTENDING
PRENATAL CLASSES 4MONITOR STRESS LEVEL
Most teens enter parenthood
Antenatal classes are good for all unprepared for the stress a
parents-to-be. They give detailed new baby brings, and many
information about labour, birth, early experience frustration,
parenting and support services. Most resentment, and even anger
hospitals have antenatal classes, and toward their newborns which
some hospitals have them especially may explain why teen parents
for younger parents.
are at higher risk for abusing and neglecting their
babies. Discuss to her doctor some ways that can
help her manage her stress levels so that she can
better cope with changes in her life and to deliver
the baby safe and healthy.
QUESTION#5
Write a brief statement on your
opinion regarding termination of
pregnancy when the woman is at
risk from the pregnancy and the
fetus is healthy.

 question #5
If we were given a chance to state our
opinion about the termination of pregnancy
because there is a risk to the mother's health
even if the fetus is healthy, we as nurses
should provide an option regarding this
matter.

The first option is therapeutic abortion.

therapeutic abortion should be done once the
client decided to feticide the pregnancy.
Therapeutic abortion is a process where
woman will undergo a safe medication process
that will terminate the client’s pregnancy in
able to save her life or if the fetus’s health is
at risk as well.
 question #5
The second option is to tell the patient that she is in
potential complications of high-risk pregnancy and can be life
threatening for the patient or the unborn baby. But getting
early and thorough prenatal care is the best way to diagnose
a high-risk pregnancy. Management for a high-risk pregnancy
will depend on the specified risk factor of the patient that
may include closer follow-up with the obstetrician,
consultation with a maternal fetal medicine (high-risk
pregnancy) specialist, consultation with other medical
specialists, more ultrasounds and closer fetal evaluation,
home blood pressure monitoring, and careful monitoring of
medications used to manage pre existing condition.

But if the health of the patient is really at risk or in danger,

we recommend labor induction or a C-Section. Labor
induction is a process of artificially starting labor to deliver a
baby. It is to speed up the process of childbirth. The main
reason this is done is to protect the health of the baby and
the mother.
 question #5
Educating the client must be done beforehand.
Consequences that will happen to her, and to the unborn
child should be discussed before the procedure. This will
allow the client to thoroughly understand the fact that she
will face a high-risk complication on their health. Also, the
client’s companion must learn all the things that they should
do — supporting the client physically mentally, and
emotionally. Moreover, encouraging the client to seek
professional help that can make sure the prevention of
having a emotional problem in the future
 Nursing Care Plan
ASSESSEMENT DIAGNOSIS PLANNING IMPLEMENTATION RATIONALE EVALUATION

SHORT TERM INDEPENDENT

SUBJECTIVE:
After 30 minutes,
None Elevated Assess and Monitor For careful After 30 mins
patient's blood
patient blood
Blood pressure will be pressure monitoring in of nursing
stabilized and changes of intervention
Pressure lowers the risk
Educate patient
OBJECTIVE related to
about appropriate client’s blood patient’s
of maternal lifestyle
pressure
pregnancy complication modification related blood
Elevated to pregnancy pressure was
as LONG TERM To enhance
Blood able to
evidenced Patient will be patient overall stabilized
Pressure Encourage patient
by edema able to deliver a to seek consultation well-being
of the limbs healthy baby to a during
Excessive with minimal risk
After 3 days
Physician/Specialists pregnancy
swelling in of maternal namely OB-GYNE of nursing
her legs and complication intervention
Provide proper patients
feet. psychological
After 3 days of support and swelling of
Fetus nursing encouragement to feet and legs
intervention, client lessen.
appears small swelling of legs
in Sonogram and feet of the
patient will
lessen.
 Nursing Care Plan
ASSESSEMENT DIAGNOSIS PLANNING IMPLEMENTATION RATIONALE EVALUATION

SHORT TERM To properly

SUBJECTIVE: INDEPENDENT assess the side
After 30 minutes, effect of a
None Elevated patient's blood certain After 30 mins
Blood pressure will be Review client’s medications that of nursing
stabilized and medication might affect intervention
OBJECTIVE
Pressure lowers the risk regimen pregnancy and patient’s
related to of maternal blood pressure blood
pregnancy complication (use of
Elevated DEPENDENT pressure was
as LONG TERM medication such
Blood Administer able to
evidenced Patient will be hypertension
as dysrhythmia
stabilized
Pressure agents,
by edema able to deliver a meds as ordered
healthy baby antihypertensiv e,
Excessive of the limbs by the Physician. diuretics, tricyclic After 3 days
with minimal risk Observe side
swelling in of maternal antidepressant s, of nursing
effects of anti- etc. can add
her legs and complication intervention
hypertensive direct effects on
feet. drugs.
patients
After 3 days of client's blood
swelling of
nursing pressure)
Fetus feet and legs
intervention, lessen.
appears small swelling of legs To be able to
in Sonogram and feet of the provide a proper
patient will medical advice
lessen. and follow ups
 Nursing Care Plan
ASSESSEMENT DIAGNOSIS PLANNING IMPLEMENTATION RATIONALE EVALUATION

SHORT TERM
SUBJECTIVE: INDEPENDENT
After 30 minutes, To ease
None Elevated patient's blood pregnancy After 30 mins
Blood pressure will be Review client’s anxiety of nursing
stabilized and medication intervention
OBJECTIVE
Pressure lowers the risk regimen
related to For immediate patient’s
of maternal
pregnancy complication stabilization blood
Elevated DEPENDENT pressure was
as LONG TERM of blood
Blood Administer able to
evidenced Patient will be pressure of
Pressure hypertension stabilized
by edema able to deliver a meds as ordered the patient
of the limbs healthy baby by the Physician.
Excessive with minimal risk
After 3 days
Observe side of nursing
swelling in of maternal effects of anti-
her legs and complication intervention
hypertensive
feet. drugs.
patients
After 3 days of swelling of
Fetus nursing feet and legs
intervention, lessen.
appears small swelling of legs
in Sonogram and feet of the
patient will
lessen.
 References
Kattah, A. G., & Garovic, V. D. (2013). The management of
hypertension in pregnancy. Advances in chronic kidney
disease, 20(3), 229–239.
https://doi.org/10.1053/j.ackd.2013.01.014

Unknown, U. (2020, January 31). Adolescent Pregnancy.

Retrieved from World Health Organization:
https://www.who.int/news-room/fact-
sheets/detail/adolescent-pregnancy

Therapeutic abortion: Medical. Winchester Hospital. (n.d.).

Retrieved September 8, 2022, from
https://www.winchesterhospital.org/health-library/article?
id=101274