Assignment Practicum Journal Entry: Reflect On A Patient I
Assignment Practicum Journal Entryreflect On A Patient Who Is Beyon
Assignment: Practicum – Journal Entry Reflect on a patient who is beyond 20 weeks gestation and presented with a health problem that commonly arises during pregnancy. Describe the patient’s personal and medical history, drug therapy and treatments, and follow-up care. Then, explain the implications of the patient’s health problem. If you did not have an opportunity to evaluate a patient with this background during the last eight weeks, you may select a related case study from a reputable source or reflect on previous clinical experiences.
Paper For Above instruction
The practicum experience is an essential component of nursing education, providing students with the opportunity to integrate theoretical knowledge with real-world clinical practice. In this context, the focus is on a patient beyond 20 weeks of gestation presenting with a common pregnancy-related health problem. This paper reflects on such a patient, detailing personal and medical histories, interventions, and follow-up care, as well as discussing the broader implications of this health issue.
A typical case involves a 28-year-old pregnant woman at 28 weeks gestation diagnosed with gestational hypertension, a common condition characterized by elevated blood pressure after 20 weeks of pregnancy. This health problem can pose significant risks to both mother and fetus, including preeclampsia, preterm birth, and placental abruption. Managing this condition requires a comprehensive understanding of the patient's health background, current therapeutic interventions, and diligent follow-up care.
Patient Background and Medical History
The patient is a G2P1 woman with a history of mild preeclampsia in her previous pregnancy, which was managed effectively with antihypertensive medication. She has no chronic illnesses such as diabetes or renal disease and reports no allergies to medications. Her personal history reveals a healthy lifestyle with no smoking or substance abuse, although she reports occasional alcohol consumption. Her obstetric history indicates a full-term spontaneous vaginal delivery and no previous pregnancy complications besides the preeclampsia episode.
Current Medical Presentation and Therapy
At the current prenatal visit, the patient reports a persistent headache, visual disturbances, and mild swelling of her feet. Blood pressure readings are elevated at 150/95 mmHg. Laboratory tests reveal proteinuria, confirming gestational hypertension. The treatment plan includes initiating antihypertensive therapy with labetalol to control blood pressure, along with the continuation of regular fetal monitoring through ultrasound assessments. The patient is advised on lifestyle modifications, including reduced salt intake and activity restrictions.
Follow-Up Care and Monitoring
Follow-up involves close monitoring of maternal blood pressure, fetal growth, and well-being. The patient is instructed to perform daily blood pressure measurements at home and maintain a symptom diary. Regular laboratory tests are scheduled to detect progression to preeclampsia, such as checking liver enzymes and platelet counts. In some cases, delivery may be considered once fetal maturation is adequate and maternal condition stabilizes, usually around 37 weeks, if the condition worsens.
Implications of the Health Problem
Gestational hypertension significantly impacts maternal and fetal health. Maternal risks include progression to preeclampsia, eclampsia, placental abruption, and increased risk for cardiovascular disease later in life. For the fetus, risks involve intrauterine growth restriction, preterm birth, and associated neonatal complications. Early detection and management are crucial to mitigate adverse outcomes. Educating the patient about recognizing warning signs, medication adherence, and routine prenatal visits forms a cornerstone of effective management.
Conclusion
This case underscores the importance of vigilant prenatal care, early diagnosis, and prompt intervention in managing pregnancy-related health issues such as gestational hypertension. Nurses and healthcare providers play a vital role in patient education, monitoring, and coordinating care to ensure the health and safety of both mother and fetus. Additionally, understanding the implications of such conditions helps inform strategies to reduce risks and improve pregnancy outcomes.
References
- American College of Obstetricians and Gynecologists. (2021). Practice Bulletin No. 222: Gestational Hypertension and Preeclampsia. Obstetrics & Gynecology, 137(2), e1–e25.
- Brown, M. A., et al. (2018). Hypertensive disorders of pregnancy: ISSHP classification, diagnosis & management recommendations. Pregnancy Hypertension, 13, 1-20.
- Huynh, S., et al. (2020). Management of Hypertensive Disorders in Pregnancy. Journal of Clinical Medicine, 9(9), 2807.
- Hantoushzadeh, S., et al. (2018). Fetal and maternal outcomes of hypertensive disorders during pregnancy: a comprehensive review. International Journal of Women's Health, 10, 563-574.
- Lisonkova, S., et al. (2018). Maternal and neonatal outcomes in hypertensive disorders of pregnancy: a population-based cohort study. BMJ Open, 8(10), e022956.
- Lee, S. K., et al. (2019). Preeclampsia and long-term maternal cardiovascular health. Obstetrics & Gynecology Science, 62(4), 301-310.
- National Institute for Health and Care Excellence. (2019). Hypertension in Pregnancy. NICE guideline [NG133].
- Redman, C. M., & Sargent, J. M. (2005). Preeclampsia, the placenta and the maternal systemic inflammatory response – a review. Placenta, 26 Suppl A, S40–S45.
- Williams, P. J., et al. (2020). Therapeutic management of hypertensive disorders of pregnancy. Australian & New Zealand Journal of Obstetrics & Gynaecology, 60(4), 498-505.
- World Health Organization. (2018). Guideline: Hypertension in Pregnancy. WHO Press.