5550 8

MSN 5550 Health Promotion: Prevention of Disease Case Study Module 8 Instructions: Read the following case study and answer the reflective questions. Please provide evidence-based rationales for your answers. APA, 7th ed. must be followed. Due: Saturday by 23:59 pm

CASE STUDY: Active Labor: Susan Wong Mrs. Wong, a first-time mother, is admitted to the birthing suite in early labor after spontaneous rupture of membranes at home. She is at 38 weeks of gestation with a history of abnormal alpha-fetoprotein levels at 16 weeks of pregnancy. She was scheduled for ultrasonography to visualize the fetus to rule out an open spinal defect or Down syndrome, but never followed through. Mrs. Wong and her husband disagreed about what to do (keep or terminate the pregnancy) if the ultrasonography indicated a spinal problem, so they felt they did not want this information. Reflective Questions

1. As the nurse, what priority data would you collect from this couple to help define relevant interventions to meet their needs?

2. How can you help this couple if they experience a negative outcome in the birthing

suite? What are your personal views on terminating or continuing a pregnancy with a risk of a potential anomaly? What factors may influence your views?

3. With the influence of the recent Human Genome Project and the possibility of

predicting open spinal defects earlier in pregnancy, how will maternity care change in the future?

Answer:

Reflective Questions:

1. Priority Data Collection: As the nurse, it’s essential to collect comprehensive data to provide appropriate care for Mrs. Wong and her husband. Priority data to collect include:
   • Mrs. Wong’s current physical condition, such as vital signs, cervical dilation, and contraction pattern, to assess her progress in labor.
   • Mrs. Wong’s obstetric history, including any previous pregnancies, prenatal care, and medical history, to understand her overall health status.
   • The couple’s emotional and psychological state regarding their pregnancy and the potential risk of fetal anomalies, including their decision-making process and coping mechanisms.
   • Any cultural or religious beliefs that may influence their decision-making and preferences for care.
   • Any previous discussions or decisions made regarding the possibility of fetal anomalies and their impact on the couple’s preferences for care during labor and delivery.

   By gathering this information, the nurse can tailor interventions to meet the couple’s physical, emotional, and cultural needs effectively.

2. Supporting the Couple in Case of a Negative Outcome: In the event of a negative outcome during labor, such as the discovery of a fetal anomaly, it’s crucial for the nurse to provide sensitive and non-judgmental support to the couple. This includes:
   • Creating a safe and supportive environment for the couple to express their emotions, fears, and concerns.
   • Offering clear and honest communication about the situation, including medical implications and available options for care.
   • Respecting the couple’s autonomy and decisions regarding their pregnancy, whether they choose to continue or terminate.
   • Providing access to counseling services and support groups to help the couple process their emotions and make informed decisions.
   • Advocating for the couple’s wishes and preferences within the healthcare team, ensuring they receive compassionate and respectful care.

   Personal views on terminating or continuing a pregnancy with a potential anomaly may vary among healthcare providers. Factors influencing these views may include personal beliefs, cultural background, professional ethics, and previous experiences caring for patients in similar situations. Regardless of personal views, it’s essential for healthcare providers to uphold ethical principles, respect patient autonomy, and provide unbiased support and information to facilitate informed decision-making.

3. Impact of the Human Genome Project on Maternity Care: The Human Genome Project has revolutionized healthcare by providing insights into genetic predispositions, disease risks, and personalized medicine. In maternity care, the ability to predict open spinal defects and other anomalies earlier in pregnancy can have significant implications:
   • Early detection of fetal anomalies allows for timely interventions, including medical management, surgical procedures, and prenatal counseling.
   • It may facilitate more informed decision-making for expectant parents regarding pregnancy continuation, termination, or adoption.
   • Advances in prenatal screening and genetic testing may lead to more personalized and targeted approaches to prenatal care, including tailored counseling and support services.
   • Healthcare providers will need to stay updated on the latest genetic testing technologies, ethical considerations, and guidelines for counseling and managing pregnancies with identified genetic abnormalities.

   Overall, the integration of genetic information into maternity care holds the potential to improve outcomes for both mothers and babies, but it also poses ethical, legal, and social challenges that must be carefully addressed.