Nutrition in Pregnancy
• The school nurse evaluates a 17-year-old high school senior, who identifies as female, using the pronouns
... [Show More] she/her/hers.
• During a visit to the clinic, she complained of nausea and “just being so tired.”
• The client reports that she wakes up most mornings for the past 2 weeks so sick she can barely get out of bed.
• The client states she does not want to eat because she hates to throw up.
• Student states she is sleeping 10 to 12 hours a night and wants to nap during the day.
• When questioned by the nurse, the client denies having a period for about 2 months and upon further questioning, the nurse determines that it is possible the client is about 11 weeks pregnant.
• The pregnancy is confirmed with a urine pregnancy test.
• The school nurse refers the client to the high school pregnancy clinic where they complete an assessment and begin prenatal care with the resident nurse midwife.
Physical assessment
• Physical assessment reveals the client weighs 48.5 kgs (106.7 lb.) and is 65 inches tall.
• Her apical pulse is 106, respiratory rate (RR) 18, blood pressure (BP) 106/66, temperature (temp) 98.4, and oxygen saturation (SpO2) is 98% at initial assessment.
• Fetal heart rate (FHR) by ultrasound is 144 bpm.
• The client denies taking any medications, supplements, alcohol, or tobacco use.
• The client states no allergies to food or medications.
• The client states this is the first pregnancy and has only been sexually active with one partner and only for a few months.
• What is her gravida/para and GTPAL?
• G1-T0-P0-A0-L0
• Denies use of any contraception.
Background
• The client is single, lives with her parents, is a cheerleader, has a GPA of 3.6, and plans to attend community college after graduation in a few months.
• The client denies being in a long-term relationship and begs the midwife to “not tell anyone about this pregnancy, not my parents, not anybody!”
• Prenatal laboratories are drawn, and a second appointment at the pregnancy clinic is made for 2 weeks to assess nausea and review laboratory work.
• Daily prenatal vitamins have been given to the client to begin taking each morning.
1. Highlight or place a checkmark next to the assessment findings that require follow-up by the nurse.
• Single 17-year-old female
• High school student
• Lives with parents
• HR 106
• RR 18
• BP 106/66
• Urine pregnancy test
• FHR 144 bpm
• Medication use
• Supplement use
• Alcohol/tobacco use
• Height
• Weight
• Contraception
• Nausea
• Sleep pattern [Show Less]