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?
- As the nurse, what priority data would you collect from this couple to help define relevant interventions to meet their needs?
In this situation, it’s essential to gather information that will allow you to provide the best care and support for Mrs. Wong and her husband. Some priority data to collect include:
- Medical History: Obtain detailed information on Mrs. Wong’s medical history, including any pre-existing medical conditions, past pregnancies, and her abnormal alpha-fetoprotein levels. This information is crucial for understanding her overall health and potential risks.
- Current Health Status: Assess her current health status, including her vital signs, uterine contractions, and fetal heart rate. Monitoring her condition is vital during labor.
- Psychosocial Assessment: Conduct a sensitive psychosocial assessment to understand the emotional and psychological state of both Mrs. Wong and her husband. Explore their feelings, fears, and concerns related to the pregnancy, delivery, and any potential anomalies.
- Communication and Decision-Making: Ask the couple about their current wishes and preferences regarding information on the fetal condition. Ensure they have an opportunity to discuss their concerns and make informed decisions.
- Legal Considerations: In some regions, there may be legal or ethical requirements regarding the disclosure of certain prenatal test results. Determine if there are any legal implications that must be addressed.
- Cultural and Religious Beliefs: Inquire about any cultural or religious beliefs that might influence their decisions and preferences related to pregnancy and childbirth.
- 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?
Providing support to a couple experiencing a negative outcome during labor is a delicate task. As a nurse, you can:
- Offer Emotional Support: Be empathetic and compassionate, actively listening to their concerns and fears. Provide a safe space for them to express their emotions.
- Facilitate Communication: Encourage open and honest communication between the couple, their healthcare team, and any necessary specialists. Ensure they have access to information and counseling services.
- Respect Their Decision: Regardless of your personal views, it is essential to respect the couple’s autonomy and their decision-making process. Your role is to provide information and support, not to impose personal beliefs.
Personal views on terminating or continuing a pregnancy with a risk of potential anomalies can vary widely among healthcare professionals. Factors that may influence your views include:
- Ethical Beliefs: Your personal ethical framework and moral beliefs may shape your perspective on termination of pregnancies with potential anomalies.
- Religious Beliefs: If you have strong religious convictions, they may influence your stance on this issue.
- Cultural Sensitivity: Your awareness of and respect for the cultural diversity of your patients can also impact your views.
- Professional Ethics: Nursing ethics dictate that patient autonomy and informed decision-making should be respected. Your duty is to support the patients in their choices.
- 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?
The Human Genome Project and advancements in genetic testing have the potential to transform maternity care in several ways:
- Early Detection and Intervention: Genetic testing can identify potential anomalies earlier in pregnancy, allowing for more time to plan for interventions and support. This could lead to earlier medical or surgical interventions if necessary.
- Informed Decision-Making: Expectant parents will have more information about the health of their unborn child. This can facilitate informed decision-making regarding the continuation of the pregnancy and potential medical interventions.
- Personalized Care: Genetic information can lead to more personalized and targeted care plans, tailored to the specific needs of the mother and the fetus.
- Emotional and Psychological Support: With early detection, there may be an increased need for psychological and emotional support for expectant parents facing difficult decisions.
- Ethical and Legal Considerations: The increased availability of genetic information may raise complex ethical and legal questions regarding issues like informed consent, privacy, and the use of genetic data.
- Healthcare Resources: The integration of genetic testing may require additional training for healthcare professionals and allocation of resources to support these new aspects of maternity care.
Maternity care in the future is likely to become more complex and multidisciplinary, with a focus on supporting expectant parents through difficult decisions while leveraging the benefits of early genetic information to improve outcomes for both mothers and infants.