CASE: Jean Mulberry is a 35 year old married female seeing the… CASE: Jean Mulberry is a 35 year old married female seeing the doctor for the first time to confirm a home pregnancy test. She works full-time as an accountant. Her OB history includes a miscarriage at 19 weeks and 23 weeks, along with twin delivery at 36 weeks, and a vaginal delivery at 38 weeks gestation. She expresses ambivalence about the pregnancy stating, “I’m really scared. We had agreed to wait for another year until we had a down payment for a house.” ASSESSMENT: She is complaining of tender breasts, fatigue, leukorrhea, increased urinary frequency, and intermittent nausea. Her LMP was January 2. Focus questions: What is Jean’s GTPAL and due date, according to Naegele’s Rule? (2 point) What assessment data does the nurse need to obtain from Jean now and throughout the antepartum period that would identify risks to the pregnancy? (Explore things that are not already identified) Identify these based on categories of risk: (4 points) Biophysical Psychosocial Sociodemographic Environmental Illustrate the normal changes of pregnancy, using the included body diagram. Be thorough and use various colors. Include the drawing with this case. (5 points) List at least 4 expected changes/common complaints due to pregnancy and interventions to alleviate them. (4 points) ASSESSMENT: In assessing Jean’s nutrition, the nurse finds she is having 1-2 glasses of wine each night with dinner. Also, she states, “Milk makes me sick- I cannot stand the sight or smell of it.” Focus Questions (1 point each):How can the nurse assess Jean’s nutritional status? Should Jean modify her diet to support her pregnancy? If so, how? What suggestions might the nurse give to Jean regarding her dislike of milk? What nutritional supplements are indicated? How should the nurse counsel in regard to Jean’s wine consumption? Complete the following table by stating the importance of the following ingredients for health maternal adaptation to pregnancy and optimal fetal growth and development (5 points)Nutrient Importance for pregnancy Common food sourcesIron Folic acid (B9) Calcium Vitamin B 6 Vitamin A Devise a sample daily menu to meet the nutritional requirements of this patient according the guidelines from MyPlate. (4 points) Health Science Science NursingNUR 4827
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