Question

Choose two of the most common complications in pregnancy. Develop a brief case study describing your patient, her history, how far along in her pregnancy she is, and how you would treat this patient, both physiologically and emotionally. This case study should mimic a provider's note and be 500 words or less.

Answer 1

Pregnancy most common complications:

Complication 1:

During pregnancy, the female urinary tract undergoes profound physiologic changes that facilitate the development of acute pyelonephritis. UTIs are the most common medical complication of pregnancy. The risk of asymptomatic bacteriuria increases with increasing parity, lower socioeconomic status, increased age, sexual activity, sickle cell trait or disease, diabetes, and previous UTI.

As early as 7 weeks' gestation, a physiologic hydroureter develops from the hormonal effects of progesterone, which causes ureteral atony, increased ureteral volume, and urinary stasis. Mechanical obstruction from the enlarging uterus also delays ureteral emptying function. Physiologic bladder changes, including decreased smooth muscle tone, increased capacity, and incomplete emptying, predispose pregnant women to vesicoureteral reflux and ascending pyelonephritis. The urinary tract returns to normal size and function by 6 weeks' postpartum.

Complication 2:

The second most common complications of pregnancy is Premature rupture of membrane (PROM). Antepartum complications can lead to high risk of pregnancy which includes increased probability of poor maternal or fetal outcome.

Complications can occur due to the following types of factors:

1. Medical: Pre-existing diseases such as e. g. diabetes, anemia, heart disease, herpes, etc. Also medical factors include genetic and lifestyle factors

2. Reproductive: It includes previous obstetric factors such as preterm labor and delivery, cesarean sections, pregnancy induced hypertension grand and multiparity

3. Psychosocial: these factors include access to prenatal care, social support systems, adaptation to pregnancy and client compliance

Treatment and nursing care:

1. Bedrest

2. no digital or speculum exams (no tampons)

3. frequent NSTs and fetal monitoring

4. MgSO4 for preterm labor

5. betamethasone if delivery anticipated

6. Immediate delivery if vaginal bleeding includes fetal blood (KOH test)

Case study:

Mrs. Meriwether is a 22-year-old female exhibits several conditions related to her urinary and reproductive systems.

Remarkable Signs on Physical by Systems

Urinary system: Leakage of urine through the urethra during Valsalva maneuver

Reproductive system: Soft mass protruding through the vagina, mostly when the patient is pushing

While the conditions may or may not be related, it is important as a medical professional to have a good understanding of these systems and potential disorders that affect them. The physician ordered the following tests: a Urine culture, a urine C&S, and a KUB. The U/A revealed pyuria, bacteria, and a slightly acidic pH. X-rays revealed acute pyelonephritis resulting from cystitis which has spread up to the kidney from the bladder. In this module, you will explore the disorders that Mrs. Meriwether has, as well as other disorders that you will run across in your career.

Solution: She has problem in her urinary tract. It may in bladder. the symptoms of this condition is given below.

Stress urinary incontinence

Cystocele- it causes the bulges of bladder into vagina.

an episode of gastroenteritis- it is also normal condition may occur due to viral infection.

Whitish and cottage cheese-like vaginal discharge- Sign of the thrush occurred. It is a normal condition.

Urine culture; The urine culture is used to diagnose a urinary tract infection (UTI) and to identify the bacteria or yeast causing the infection. Results of a urine culture are often interpreted in conjunction with the results of a urinalysis and with regard to how the sample was collected and whether symptoms are present. Typically, the presence of a single type of bacteria growing at high colony counts is considered a positive urine culture.

KUB; KUB stands for kidneys, ureters and bladder and refers to a diagnostic technique of radio imaging of these three parts of body to determine any type of inflammation in them.