Question

Case Scenario:

Ruba is a 39 years old, pregnant woman at 8 weeks gestation, and her husband, Ali, is 50 years old, arrives at antenatal clinic for follow-up. The couples have been married for 12 years. Ruba completes the initial paperwork, and the nurse notes the following obstetric history: G6 T0 P0 A5 L0 M0. Ruba and Ali asked the nurse many questions regarding Down syndrome as Ali’s sister, recently, has a boy with Down syndrome.

Q1. What are the initial prenatal assessment and screening tests would the nurse anticipate for Ruba at this antenatal visit?

Q2. As Ruba has many questions regarding her pregnancy, including the physiological and psychological changes, labor process and postpartum period. The nurse advice Ruba and Ali to attend antenatal classes.

List six topics should be covered in the childbirth preparation program that may help to answer Ruba’s inquiries

Answer 1

Q1. What are the initial prenatal assessment and screening tests would the nurse anticipate for Ruba at this antenatal visit?

:- collect comprehensive health history

:-collect date of last menstrual period

:-assessment of about any allergies

:-Nurse will measure your blood pressure.height and weight

:-Breast and pelvic examination

:-Pap test

:-blood test for grouping, anemia and other medical genitic conditions

:-A blood test and a specialized ultrasound test to assess the babies risk for Down syndrome or trisomy 18 (usually done in 9 to 10 th week )

Q2. As Ruba has many questions regarding her pregnancy, including the physiological and psychological changes, labor process and postpartum period. The nurse advice Ruba and Ali to attend antenatal classes.

List six topics should be covered in the childbirth preparation program that may help to answer Ruba’s inquiries

1 Prenatal Care

• It is important to begin prenatal care as early as possible in the pregnancy. It may help reduce possibility of preterm labour.
• A checkup before conceiving will help you prepare for pregnancy. Early and regular prenatal care will help you have a healthy pregnancy and baby.
• Prenatal care includes regular visits with a health care provider, and may also include various tests and procedures to monitor the health and well‐being of mother and baby.
• Health care providers are interested in both the physical and emotional well‐being of the mother and partner during pregnancy.
• There are benefits to including the partner/support person in prenatal care. (Caution to prenatal educator : This may not be appropriate in abusive situations, so, word carefully.)
• Expectant parents have the opportunity to speak with the health care provider about their concerns and the changes that are occurring. They can ask questions, share what is important to them and be involved in making all decisions about their care.
• Health care providers will identify community services that may provide support. These include: hospital or birthing centre, prenatal education, public health, social services, etc.

2. Changes in Pregnancy
   Common Changes - First Trimester
  Coping with nausea and vomiting
1Get out of bed slowly.
2Eat small, healthy meals and snacks.

3Eat foods that appeal to you.
4Avoid spicy, fried, or fatty foods.

Coping with fatigue:
1Pay attention to your body and rest when you are tired.
2Take naps during the day. Accept help from family and
friends

Coping with urgency:
1Drink less in the evening.
2Go to the bathroom every time you have an urge to urinate.
3Make sure your bladder empties completely.

   Coping with feeling faint:
1Take your time when getting
2Eat small, healthy meals and snacks.
3Contact your health care provider if the feeling
does not go away.
4If you feel faint, sit down and put your head between your knees.
Loosen tight clothing.
5Place a cool cloth on your forehead or back of your neck.
6Eat iron rich foods.

.

3. Healthy Eating

Baby-building Nutrients
:-Folate (Folic Acid) and vitamin C Carbohydrates and fiber Calcium and vitamin D ,Iron and protein ,Omega 3  Fats

Foods to Avoid
:-Fish containing high listeriosis, levels of Excess caffeine ,Liver and liver products

Omega-3 Fats   Dietary sources of omega
Fatty fish like salmon, trout, mackerel, sardines,
Some seafood like mussels
Flaxseed and flaxseed Soy beans and soybean Canola oil.
Walnuts.
Some seaweed

4. Physical & Emotional Fitness

Pregnancy Stress
Physical discomforts Hormonal changes,Health of mother & baby ,Changing relationships, Financial concerns

Strategies for Coping
Determine the source of stress,Eat healthy, be physically active regularly, get enough sleep
,Ensure you have a reliable support network

Benefits of Active Living
less stress
More energy
More oxygen for your baby
A healthy weight
Less risk of developing pregnancyrelated diabetes
- or high blood
An easier recovery after birth

5. Environmental Exposures

Explain how to be free from alcahol,drugs,tobacco and smoking and how important it is for babies health

6. Labour and Birth

Getting Ready for Labour and Birth During your last few months:

:-Attend prenatal education classes.Discuss your birth plan.Learn about breastfeeding .Make a list of phone numbers you need.Plan your maternity leave.

7. Comfort Measures

• There are many different options to help you cope with labour pain. Before labour, it can be helpful to review and even practice some these comfort measures to learn what may work best for you. During labour, do what makes you feel most comfortable.
• Your health care provider might discuss information that you do not fully understand during labour and birth. Ask questions until you understand. This may ease any anxieties that you, your partner, and/or other support people might have. It will help you make informed decisions that are best for you and your baby.
• It may be helpful to refer back to your birth plan/birth preferences during labour to remind you of coping techniques you had hoped to use.
• When planning an unmedicated birth, it may be helpful to chose a code word to indicate that you truly want or need medical assistance to cope with your pain, instead of needing more or different support.