1. Assignment: Practicum – Journal Entry

Reflect on a patient who presented with a breast condition during your Practicum Experience. Describe the patient’s personal and medical history, drug therapy and treatments, and follow-up care. Then, explain your patient education strategies for patients with or at risk of breast conditions. Include a description of how you might teach patients to perform breast self-examinations. If you did not have an opportunity to evaluate a patient with this background during the last six weeks, you may select a related case study from a reputable source or reflect on previous clinical experiences.

2. Discussion: Care Plans for Pregnancy

After confirming and dating a pregnancy, you must collaborate with patients to develop a personalized care plan. These pregnancy care plans are integral to prenatal care as they help to ensure the mother and child’s well-being throughout the entire pregnancy. Pregnancy can be a wonderful, yet difficult time for women as a woman’s body goes through many physical, mental, and emotional changes that might be challenging or even overwhelming for some. Whether or not these women share their concerns, as the advanced practice nurse, you must routinely watch for signs and symptoms of any developing physical or mental health issues. By collaborating with patients and discussing concerns, you can modify care plans and often address potential issues before they become a significant health problem. For this Discussion, consider pregnancy care plans for the women in the following case studies:

Case Study 1:

On 1-15-13, you are seeing a 25-year-old Caucasian female in the clinic because she believes she’s pregnant. Her LMP was 12-1-12. Her home pregnancy test was positive, and she has been having nausea and breast tenderness.

Case Study 2:

You are seeing a 28-year-old African American female, G6 P 3115, who is currently on oral combined hormonal contraception. She’s here because she and her partner would like to have another child. She heard “it takes a while to become pregnant after being on the Pill,” so she discontinued them three months ago. They haven’t been using any contraception since then. Upon questioning, she states that on the Pill, sometimes her menstrual periods are very light and once she didn’t have one at all. Her urine pregnancy test in the clinic is positive. Her LMP was 7-14-12. You are seeing her on 12-3-12.

To prepare:

• Review Chapter 30 of the Schuiling and Likis text and Chapter 2 of the Tharpe et al. text.
• Review and select one of the two provided case studies. Analyze the patient information.
• Consider how to date the pregnancy and estimate the date of delivery for the patient in the case study you selected.
• Based on the dating of the pregnancy, reflect on the appropriate clinical guidelines for procedures and screenings. Think about the implications of any missed procedures or screenings.
• Determine a plan of care for the patient. Identify procedures, screenings, diagnostic testing, pharmacologic and nonpharmacologic treatments (if appropriate), management strategies, and patient education.

Post the estimated date of delivery for the patient in the case study you selected. Include an explanation of how you dated a pregnancy and which of the patient’s factors led to your estimated date of delivery. Then, based on the dating of the patient’s pregnancy, explain the appropriate clinical guidelines for procedures and screenings. Explain implications of any missed procedures and/or screenings. Finally, explain a plan of care for the patient, including procedures, screenings, diagnostic testing, pharmacologic and nonpharmacologic treatments, management strategies, and patient education.

3. Discussion: Health Promotion During Pregnancy

When caring for pregnant women, it is important to care for the whole person. This means you not only manage the pregnancy and treat conditions, but you also promote healthy behaviors and good lifestyle choices. Through health promotion, you can help to ensure the safety of both the mother and the baby. Your role in health promotion is to identify health risks that might result in pregnancy complications, educate patients on these risks, and provide the necessary support to help patients mitigate these risks. In this Discussion, you examine implications of drug use, alcohol consumption, dietary habits, and environmental exposures during pregnancy, and you consider ways to educate pregnant women about such risks.

To prepare:

• Review Chapter 2 of the Tharpe et al. text and the article from the Centers for Disease Control and Prevention in this week’s Learning Resources.
• Consider lifestyle changes that pregnant women must make in relation to smoking, drinking, taking drugs (legal and illegal), eating habits, and caring for pets. Select one of these topics to be the focus of an educational media piece you would create for health promotion during pregnancy.
• Think about the patient population that you treat within your practicum setting. Consider ways to educate these patients on health promotion as it relates to the topic you selected. Then, consider the types of educational pieces, such as flyers, posters, public service announcements, or other media, that might be most effective with your patient population.

Post a detailed description of the educational media piece you would create for health promotion during pregnancy. Explain why you selected the particular topic, as well as why you selected the type of media and how and why it is suitable for your patient population.

Note: If you have an educational media piece that you would like to share, attach the file to your Discussion posting.

4. Assignment 1: 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.