Acute Care Patient Case Paper
OB Clinical Case Study
NURS 332- The Growing Family

Purpose of Assignment

 The purpose of this paper is for the student to conduct an in-depth assessment of a childbearing woman and her family in order to plan nursing care specific to that client, based on nursing research and AWHONN Standards of Care. The assessment will include the appropriate physiological, psychological, social, cultural, and environmental influences pertaining to the client and her family as it relates to preconception, conception, antepartum, intrapartum, postpartum and neonatal care.     

Student Approach to Assignment

Taking on this assignment, I gathered all my knowledge from lecture and clinical experiences in my obstetrics nursing undergraduate course. I gathered pertinent data on a patient and family of my choosing by using the skills and assessment techniques utilized by bachelors prepared registered nurses. The assignment allowed me to study a woman and her family as she/they transitions through the stages of the childbearing process and explain the care given as it relates to the nursing process.   

Reason for Inclusion of this Assignment in the Portfolio

This required assignment is relevant for inclusion because it depicts the knowledge, assessment techniques, and AWHONN standards of Care I have utilized and developed during my undergraduate obstetric nursing course. In this assignment I demonstrate a understanding of the multidimensional nursing care that is involved in caring for a woman and her family in the different stages of childbearing. 

1. Critical Thinking

   •  Evaluates nursing care outcomes through the acquisition of data and the questioning of inconsistencies

     • Example: I believe that I met this first criteria in the Nursing diagnosis portion of this paper. In this section I explain the data and concerning inconsistency that led me to my primary and secondary nursing diagnosis for my patient. I also explain the subsequent nursing care and project outcomes I hope to attain. For example, in this section I explain that based on assessment data that reviled my patient to be morbidly obese with a history of smoking, I assigned the nursing diagnosis of ineffective health management. Given this diagnosis I planned to initiate weight loss strategy teachings and smoking cessation techniques. Finally, I explain that I would evaluate the favorable nursing outcomes of my patient’s ability to describe positive effort to lose weight and verbalization of benefits to smoking cessation to gauge the effectiveness of the nursing care.

1. Nursing Practice

   •  Applies appropriate knowledge of major health problems to guide nursing practice

     • Example: I believe that I have met this criterion in the nursing diagnosis portion of the case analysis. Here I mention that my patient was exhibiting clinical signs of +3 pitting edema. I go on to mention that, although edema is not uncommon in a postpartum woman, if severe enough it can have drastic consequences on hydration, fluid and electrolyte balance, and cardiac output. The understanding of this health problem led me to recommend frequent ambulation as tolerated and encouragement of consumption of any prescribed fluids. I finally explain that, these interventions are utilized to mobilize fluid in the extravascular space back into circulation. This will allow the body to utilize it properly.

1. Professionalism

   • Advocates for professional standards of practice using organizational and political processes

     • Example: This criterion is met in the Association of Women’s Health, Obstetric, and Neonatal Nurses (AWHONN) Standards of Care section of this assignment. In this section I explain how I advocated for the utilization of these standards of care as it is relevant to AWHONN. For example, I mention that one of these standards is assessment and per AWHONN this standard mandates the collection of all relevant data using evidence-based assessment techniques by all the nursing staff. However, I mention that during my time there was an instance with a patient who was making complaints to a nurse and I about arm pain and was not assessed by her nurse after this complaint. Therefore, I relayed this information to another nurse in fear of complications such as emboli or myocardial infarction. I believe that I adequately advocated for the professional standards that are set by AWHONN.

1. Research

   • Applies research-based knowledge from the arts, humanities and sciences to complement nursing practice

     • Example: I believe that I have met this criterion in the current literature portion of this assignment. In this section I explain that my patient had a history of smoking, thus placing her at a higher risk of relapse postpartum. The intervention that I have purposed in this section to mitigate the likelihood she would relapse was smoking cessation during her postpartum care. I proceed to mention a study from current nursing literature that has a 70% success rate of smoking cessation by using multiple interventions such as meetings, written material, support persons, telephone contact, and other intervention. I conclude by recommending this evidence-based intervention to help continue her recovery.

   • Evaluates research that focuses on the efficacy and effectiveness of nursing interventions

     • Example: This next criterion was also met in the current literature section of this assignment. In this section, I focused on a recent study that evaluated the effectiveness of coping strategies and intervention for parents of infants in the neonatal intensive care unit (NICU).  I mention that the study found that nursing teaching interventions, such as distance keeping and self-control, were effective for coping in this patient population. I conclude this section by explain the importance this research had to my patient, because my patient was having trouble coping with her newborn who was in the NICU postpartum. Finally, I explain that by evaluating this research I know what intervention are likely to help my patient cope.