Complication of Pregnancy Case Study

Complication of Pregnancy Case Study

Elena (2-1-0-0-1) is a 32-year-old Hispanic-American married woman in week 29 of her pregnancy.  She is obese with a BMI of 35.  Her mother, who is 59, was recently diagnosed with Type 2 Diabetes.  Elena’s first pregnancy, where she gained 65 lbs, resulted in the C-Section birth of a 10 lb 6 oz daughter, who is now two years old.  A 1-hour, 50-gram glucose screening test (sometimes called Glucola or a Glucose Challenge Test/GCT) a week ago revealed a glucose level of 152 mg/dl.  Two days ago, the indicated follow-up 3 hour Glucose Tolerance Test (GTT) revealed two values that were too high and considered abnormal.

1. Identify the complication of pregnancy Elena is exhibiting. (2 pts)

Elena is suffering from a condition known as gestational diabetes. This condition is primarily associated with type two diabetes. Given her overweight body and her family history of diabetes mellitus, Elena has a high chance of suffering from the condition. The condition is symptomatic of high glucose levels beyond normal, as indicated by the glucose screening and glucose tolerance tests.

1. Identify the potential maternal/fetal/newborn risks and complications on the grid below. (6 points)

1. Obtain a history, then develop a problem list for Elena and her family. (Think about what you would want to know to complete this information. What do you already know? List questions you would ask Elena to get more information. (8 pts)

• Health History

From the lab test, it can be noted that Elena is overweight, given her body mass index of 35. She also had a significant weight gain during her first pregnancy and also gave birth to an overweight baby. To get more information about Elena’s condition, these are the possible questions that I would ask her. Were you born overweight or the condition has developed in your later years of development? Have you ever been diagnosed with type two diabetes? If yes, what drugs were you diagnosed with? What are your current plans to monitor your body weight?

• Physical exam, clinical data, signs, and symptoms
  

The physical examination would include the examination of signs for dehydration and glucose intolerance as they are common with gestational diabetes. The examination also entails the measurement for body height and weight to determine the body mass index. The examination of blood pressure levels is also essential. Other physical examinations, such as pupillary abnormalities and eye examinations, are common with diabetic patients.

• Psychosocial/Family issues

Social and family issues are also important factors to consider in the case of Elena. Her condition can result in the onset of symptoms such as anxiety, depression, and even confusion, and that makes it important to understand her social background. To get more insights into this, it would be important to ask her questions such as how physically active are you based on a scale of 5? Do you engage in any physical activity such as going to the gym? Other than your mum, are there are any other close relatives diagnosed with type two diabetes? Do you engage in lifestyles, such as taking alcohol or smoking? Do you have any financial or support constraints that can contribute to your current condition? Have you experienced any incidences of stigmatization of discrimination because of your current condition? Have you ever been diagnosed with depression or any other related disorders?

4. What is the most important problem for Elena and her family and baby during the pregnancy and the immediate postpartum/newborn time frame? Give your rationale for choosing this problem. (2 pts)

The most important problem for Elena is that she may develop a risk for high blood pressure associated with type two diabetes. She is also a higher risk of requiring a c section during her delivery. If she gives birth to obese children, then her family is also at risk of experiencing these conditions in the future (Catalano, 2010). Elena is also at a high risk of suffering from gestational diabetes in her future pregnancies, which also exposes her to a high risk of type two diabetes in the near future.

5. Develop an appropriate nursing diagnosis for Elena and one for her baby. (4 pts)

The best nursing plan for Elena would be to start practicing a healthy lifestyle, such as eating healthy meals. She should cut down her intake of fats and calories and improve on her intake of vegetables and calories. She should also maintain an active lifestyle during and after her pregnancy (Bloomgarden, 2010). She should ensure she is physically active all along so that she can take control of her weight. Elena should also opt for planning her next pregnancy when her body weight is appropriate and as recommended by a health practitioner, which improves her life as well as that of the unborn child

6. In contrast to question #4 above, what is the most important problem for Elena’s health after her pregnancy once she has progressed past the 6-week postpartum time frame? How would her health care team screen for, educate about, and monitor for this problem? (3 pts)

Elena is at risk of developing high blood pressure after she delivers her baby. Gestational diabetes is associated with preeclampsia, which poses a great threat to the life of type two diabetic to mother after pregnancy. Elena can also be at risk of developing type two diabetes after delivery of her baby.  The healthcare team, therefore, needs to maintain a regular check of Elena’s blood pressure and sugar levels (Catalano, 2010). They also need to educate her on the importance of maintaining a healthy and physically active lifestyle so as to help improve her condition in the future.

References

Gestational diabetes. (2020). Retrieved from https://www.mayoclinic.org/diseases-conditions/gestational-diabetes/symptoms-causes/syc-20355339

Bloomgarden, Z. T. (2010). Gestational diabetes mellitus and obesity

Catalano, P. M. (2010). The impact of gestational diabetes and maternal obesity on the mother and her offspring. Journal of developmental origins of health and disease, 1(4), 208-215