Question

1. A health history interview of the pregnant woman by the nurse is included as part of the initial prenatal visit. Provide a rationale and reference for each answer. a. State the purpose of the health history interview b. Write two questions for each component that is included in the initial health history interview. Questions should be clear, concise, understandable, and open-ended. c. Write four questions that should be included in the interview when updating the health history during follow-up visits. 2. Write one nursing diagnosis, one expected outcome, and list two appropriate nursing measures for the nursing diagnosis you identified. a. A woman is 6 weeks pregnant. During the health history interview, she tells you that she has limited her intake of fluids and tries to hold her urine as long as she can because, “I just hate having to go to the bathroom so frequently.” b. A woman, who is 23 weeks pregnant, tells you that she is beginning to experience more frequent lower back pain. You note that when she walked into the exam room her posture exhibited a moderate degree of lordosis and neck flexion. She was wearing shoes with 2-inch narrow heels. c. A woman, who is a primigravida at 32 weeks of gestation, comes for a prenatal visit accompanied by her partner, the father of the baby. They both express anxiety about impending birth of the baby and how they will handle the experience of labor. She is especially concerned about how she will survive the pain and her partner is primarily concerned about how he will help her cope with labor and make sure she and the baby are safe.

Answer 1

a. The purpose of the health history interview is to gather comprehensive information about the pregnant woman's medical history, lifestyle, and any potential risk factors that may affect her pregnancy. This helps the nurse in assessing the woman's health status and providing appropriate care. (Reference: Smith, M. C., & Duell, D. J. (2019). Varney's Midwifery. Jones & Bartlett Learning.)

b. Two questions for each component of the initial health history interview:
1. Medical History:
- Have you ever been diagnosed with any chronic medical conditions? If yes, please specify.
- Are you currently taking any medications? If yes, please provide details.

2. Obstetric History:
- Have you been pregnant before? If yes, how many times and what were the outcomes?
- Have you ever had any complications during previous pregnancies? If yes, please explain.

3. Lifestyle and Habits:
- Do you smoke cigarettes or use any tobacco products? If yes, how much and how often?
- How would you describe your current diet? Do you have any specific dietary restrictions?

4. Social Support:
- Are you receiving any support from your family or partner during your pregnancy?
- Do you have any concerns or worries about your pregnancy or upcoming birth?

c. Four questions for updating the health history during follow-up visits:
1. Have there been any changes in your medical history since our last visit? If yes, please provide details.
2. How have you been feeling physically and emotionally since our last appointment?
3. Have you noticed any new symptoms or discomforts during your pregnancy recently?
4. Have there been any changes in your lifestyle or habits that may affect your pregnancy?

2. Nursing Diagnosis: Impaired Urinary Elimination related to limited fluid intake and prolonged holding of urine.
Expected Outcome: The woman will maintain adequate fluid intake and void regularly without discomfort.
Nursing Measures:
1. Educate the woman about the importance of adequate fluid intake during pregnancy and the potential risks of urinary stasis.
2. Encourage the woman to empty her bladder regularly, avoiding prolonged holding of urine, to prevent urinary stasis and potential urinary tract infections.

Please let me know if there's anything else I can assist you with!

Answer 2

Step-by-step explanation:

a. The purpose of the health history interview during the initial prenatal visit is to gather comprehensive information about the pregnant woman's health, medical history, lifestyle, and any potential risk factors. This interview helps the nurse assess the woman's overall health status, identify any existing or potential health problems, and develop an individualized care plan for the pregnancy. It also allows for the establishment of a trusting relationship between the woman and the healthcare provider.

Reference:

American College of Obstetricians and Gynecologists. (2020). Prenatal Care. ACOG Practice Bulletin No. 190. Obstetrics and Gynecology, 135(5), e51-e72. doi: 10.1097/AOG.0000000000003847

b. Two questions for each component of the initial health history interview:

Obstetric History:

Have you been pregnant before? If yes, how many pregnancies have you had, and how many children do you have?

Did you experience any complications or difficulties during your previous pregnancies, such as gestational diabetes or high blood pressure?

Medical History:

Do you have any pre-existing medical conditions, such as diabetes, hypertension, or thyroid disorders?

Are you currently taking any medications or supplements? If yes, please provide details.

Surgical History:

Have you had any previous surgeries? If yes, what type of surgeries were they, and when were they performed?

Did you have any complications or adverse reactions during or after your previous surgeries?

Social History:

Do you smoke cigarettes or use any tobacco products? If yes, how many cigarettes do you smoke per day?

Are you exposed to secondhand smoke at home or work? If yes, how frequently are you exposed?

c. Four questions for updating the health history during follow-up visits:

Have you experienced any new symptoms or changes in your health since your last visit?

Have you had any recent illnesses or infections?

Have you made any changes to your medications, supplements, or lifestyle habits?

Are you facing any new stressors or challenges that may impact your pregnancy or overall well-being?

Nursing Diagnosis: Impaired Urinary Elimination related to limited fluid intake and delayed emptying of the bladder as evidenced by the client's statement of limiting fluid intake and trying to hold urine for extended periods.

Expected Outcome: The client will maintain adequate urinary elimination patterns and demonstrate understanding of the importance of appropriate fluid intake during pregnancy.

Nursing Measures:

Assess the client's current fluid intake and educate her on the recommended daily fluid intake during pregnancy (approximately 8-10 glasses of water or other fluids).

Provide education on the importance of regular and timely emptying of the bladder to prevent urinary stasis and potential complications. Encourage the client to empty her bladder whenever she feels the urge, rather than holding it for long periods.