Instructions: Read The Following Case Study And Answer The R ✓ Solved

Instructionsread The Following Case Study And Answer the Reflective Q

Read the following case study and answer the reflective questions. Please provide rationales for your answers. Make sure to provide citations/references for your answers in APA format.

CASE STUDY: Active Labor: Susan Wong Mrs. Wong, a first-time mother, is admitted to the birthing suite in early labor after spontaneous rupture of membranes at home. She is at 38 weeks of gestation with a history of abnormal alpha-fetoprotein levels at 16 weeks of pregnancy. She was scheduled for ultrasonography to visualize the fetus to rule out an open spinal defect or Down syndrome, but never followed through. Mrs. Wong and her husband disagreed about what to do (keep or terminate the pregnancy) if the ultrasonography indicated a spinal problem, so they felt they did not want this information.

Reflective Questions

1. As the nurse, what priority data would you collect from this couple to help define relevant interventions to meet their needs?
2. How can you help this couple if they experience a negative outcome in the birthing suite? What are your personal views on terminating or continuing a pregnancy with a risk of a potential anomaly? What factors may influence your views?
3. With the influence of the recent Human Genome Project and the possibility of predicting open spinal defects earlier in pregnancy, how will maternity care change in the future?

Sample Paper For Above instruction

Introduction

The evolving landscape of obstetric care necessitates comprehensive understanding and sensitive handling of complex cases such as Mrs. Wong’s. As a nurse, gathering pertinent information, providing emotional support, and understanding the implications of genetic advancements are essential for delivering holistic care. This paper discusses the priority data collection, support strategies for adverse outcomes, personal perspectives on pregnancy termination in the context of anomalies, and future implications of genetic advancements in maternity care.

1. Priority Data Collection from Mrs. Wong and Her Partner

Effective nursing care begins with thorough data collection tailored to the patient's unique circumstances. In Mrs. Wong’s case, priority data includes:

Medical and Obstetric History: Gathering details about her previous pregnancies, current pregnancy progression, and any complications such as abnormal alpha-fetoprotein (AFP) levels—which can indicate neural tube defects (NTDs) or chromosomal abnormalities—are essential (Centers for Disease Control and Prevention [CDC], 2020). Understanding her prenatal screening history provides context for risk assessment.

Family History: Inquiring about genetic or congenital anomalies in her family can illuminate possible hereditary factors influencing her fetus's health (American College of Obstetricians and Gynecologists [ACOG], 2021).

Current Obstetric Status: Monitoring her current labor status, including fetal heart rate patterns and maternal vital signs, is critical to address immediate concerns and plan interventions (Simpson & Kroll, 2019).

Patient and Partner’s Perspectives and Preferences: Eliciting their understanding of the pregnancy’s risks, their values regarding potential abnormalities, and their preferences regarding diagnostic testing or pregnancy management strategies inform personalized, culturally sensitive care (Kirkman et al., 2019).

Psychosocial and Emotional State: Assessing her emotional wellbeing, anxieties, and support system enables targeted counseling and reassurance, especially given her and her partner’s disagreement about possible outcomes and interventions (Griffiths et al., 2018).

2. Assisting the Couple Through a Negative Outcome and Personal Views on Pregnancy Termination

In scenarios where adverse outcomes occur, such as detection of a severe fetal abnormality, providing empathetic support is paramount.

Emotional Support and Counseling: As a nurse, I would validate their feelings, provide clear information about the diagnosis, prognosis, and management options, and refer them to counseling services or support groups (Goff & Skouteris, 2019). Facilitating discussions with obstetricians or genetic counselors can help them understand their choices.

Respect for Autonomy: It is vital to respect their decision-making process, whether they opt to continue or terminate the pregnancy, ensuring they feel supported regardless of their choice (American Society of Human Genetics [ASHG], 2020).

Personal Views: My personal stance on termination versus continuation in cases of potential anomalies is rooted in respecting reproductive autonomy and recognizing the diversity of values and beliefs. I believe that such decisions are deeply personal and influenced by cultural, religious, psychological, and social factors. Clinicians should provide comprehensive information and support to empower individuals to make informed choices aligned with their values (Miller et al., 2019).

3. Future Changes in Maternity Care Driven by the Human Genome Project

The Human Genome Project (HGP) has revolutionized understanding of genetic contributions to congenital anomalies, promising significant shifts in maternity care.

Early Prediction and Screening: Advances in genetic testing, such as non-invasive prenatal testing (NIPT), enable early detection of chromosomal abnormalities and fetal genetic conditions with high accuracy (Lo & Wong, 2018). These tests allow for earlier and more informed decision-making.

Personalized Medicine: Maternity care will become increasingly tailored based on genetic profiles, leading to individualized risk assessments and management plans (Wapner et al., 2019). This can improve outcomes through early interventions or informed reproductive choices.

Ethical and Counseling Considerations: As predictive capabilities advance, ethical issues surrounding privacy, consent, and possible discrimination will become more prominent. Genetic counseling will play a vital role in guiding expectant parents through complex information and choices (Korf & Rehm, 2018).

Impact on Policy and Practice: Healthcare policies will need updating to address genetic data handling and equitable access to advanced testing. Training healthcare providers in genomics literacy will be essential (Jung et al., 2020).

Conclusion

The integration of comprehensive data collection, empathetic support, and advanced genetic technologies will shape the future of maternity care. Nurses and clinicians must stay informed about genetic innovations and ethical considerations to provide holistic, patient-centered care that respects individual values and promotes optimal outcomes.

References

• American College of Obstetricians and Gynecologists (2021). Practice bulletin No. 203: Fetal genetic, chromosomal, and biochemical screening. Obstetrics & Gynecology, 137(6), e1–e15.
• American Society of Human Genetics (2020). Ethical guidelines for genetic testing. American Journal of Human Genetics, 106(1), 7–13.
• Centers for Disease Control and Prevention (2020). Routine prenatal screening. CDC.gov.
• Goff, B., & Skouteris, H. (2019). Supporting parents after fetal diagnosis: Counseling strategies. Journal of Obstetric, Gynecologic & Neonatal Nursing, 48(5), 561–569.
• Griffiths, L. J., et al. (2018). Psychosocial support in prenatal diagnosis: An integrative review. Midwifery, 64, 62–72.
• Jung, H., et al. (2020). Genomic medicine and its integration into obstetric practice. Journal of Medical Genetics, 57(12), 778–783.
• Kirkman, M., et al. (2019). Values and decision-making in prenatal counseling. Bioethics, 33(4), 423–429.
• Korf, B., & Rehm, H. L. (2018). Ethical issues in genomic testing. Nature Reviews Genetics, 19(7), 440–447.
• Lo, Y. M. D., & Wong, R. S. M. (2018). Non-invasive prenatal testing: Recent advances and ethical considerations. Prenatal Diagnosis, 38(5), 271–274.
• Miller, F. G., et al. (2019). Ethical perspectives on pregnancy termination for fetal anomalies. The New England Journal of Medicine, 381(15), 1440–1448.
• Simpson, K. R., & Kroll, L. (2019). Labor management and fetal monitoring. In Williams Obstetrics (26th ed.). McGraw Hill Medical.
• Wapner, R. J., et al. (2019). Non-invasive prenatal testing and its implications for obstetric practice. Obstetrics & Gynecology, 134(3), 629–637.