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In: Nursing

At 22/6/2020, Fatma is 31 years old, case of SCD with VOC during pregnandes (scd on...

At 22/6/2020, Fatma is 31 years old, case of SCD with VOC during pregnandes (scd on Aspirin /peniclin prophylaxis /follc add), currently pregenant at 33 weeks, cames with rt knee joint pain since last night, bothg legs lookes normal, no swelling , no redness, took paracetmol with no improvement, no traum, no bites or Injuries.No SOB, no breathing difficulty, gdm on metformin 500 mgs bid, good fetal movement.
She admission at 7.6.2020 with severe aneamia ,hb was 5.6g/dl pt redeved 2pints of blood discharge on hb 9.
Pregnancy History...
Gravida 3
Surgical History...
Operated on 23/08/16 for g3 p2 preg 36 5 week with previous 2 cs (Lower segment caesarean section). Operated on 13/10/12 for 37 wks   k/c/o scd with (Lower segment caesarean section). Operated on 16/03/10 for primi 37ws scd Iscs for npol LS.CS (Primary}.
Plan:
Invistigation, rehyderation,analgesia, admission at gyne ward
thromboprophylaxis ,antibiotic, vitals monitoring, Intermittent ctg,
physian reffereal (1031) Informed, bsp inform, If needed

Part- 1
1. Analyze and specify the physical and psychological needs for this client? 2. Address the subjective and objective data included in the scenario? 3. Discuss the therapeutic management modalities provided to this client? 4. List the prognosis of this lady and possible complications and how to prevent it? 5. Write one priority nursing care plan and specify the appropriate nursing care should be provided for this client? 6. Specify health education instruction to be conveyed to this lady prior discharge?

Part-2
Discuss the following pharmacological management and justify if it is safe administration for a client suffers from GDM & SCD antenatally and postnatally (information should include the following information, classification, mode of action, indication, pregnancy category, nursing responsibility and a justification for its usage or not to the giving client)

1. Tramadol    2. Metformin 3. Heparin 4. Acetyl salicylic acid 5. Phenoxymethyl penicillin

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