Patient Scenario, Chapter 20, Nursing Care of a Family Experiencing a Pregnancy Complication from a Preexisting or Newly Acquired Illness

Patient Scenario, Chapter 20, Nursing Care of a Family Experiencing a Pregnancy Complication from a Preexisting or Newly Acquired Illness A WOMAN WITH EARLY PREGNANCY CONCERNS Paula Taylor is a 38-year-old, G1P0 seen during her 12th week of pregnancy. She was diagnosed as having sickle-cell anemia as a child. CHIEF CONCERN: “I can’t sleep at night, I am so short of breath.” HISTORY OF CHIEF CONCERN: The client entered pregnancy without any feeling of shortness of breath. Since 2 weeks ago, she has been extremely fatigued, has mild constant swelling in her ankles, a persistent cough, inability to walk upstairs without becoming breathless, and orthopnea so severe at night she cannot sleep without four pillows. FAMILY PROFILE: The client is a massage therapist in boutique spa. Her boyfriend is a plumber. The client states she has to continue working because her husband does not earn enough to pay the mortgage on their house without her help. The main reason is, though, she says, “I’ll go crazy without people to talk to. I’m a people person.” She does not smoke and no alcohol ingestion since pregnant. HISTORY OF PAST ILLNESSES: She developed scoliosis as an early adolescent. She has retainer rods inserted to support her spine. HISTORY OF FAMILY ILLNESSES: One aunt has breast cancer; an uncle has arteriosclerotic heart disease. Her sister has recurrent absence seizures. A cousin has type 1 diabetes mellitus. DAY HISTORY: This study source was downloaded by from CourseH on :32:45 GMT -06:00 Nutrition: 24-hour recall: Breakfast: 1 serving oatmeal with raisins; 1 glass orange juice; 1 cup coffee Lunch: 1 tuna fish sandwich; 1 serving salad; 1 cup coffee Dinner: 1 pork chop; 1 serving potatoes; 1 serving spinach; 1 cup coffee Snacks: Eats ice cubes almost constantly to relieve heartburn; has a craving to eat the “lead” in pencils Sleep: Tries to sleep 8 hours a night but receives only 3 to 4 hours because of constant waking with shortness of breath Recreation: Enjoys talking to chat r