Pregnant Client Case Study

• Discuss the nutritional needs of a pregnant client. What challenges are there to meet the needs of pregnant clients specifically related to socioeconomic and/or cultural practices? Identify at least two. Use the nursing process.

Maintaining good eating habit is important regardless of a person’s life cycle. During pregnancy such habit is even more necessary as the mother is also feeding the fetus. Therefore, there has been some guidelines set forth to inform pregnant woman and encourage them to maintain daily intakes of nutrients that are essentials to both the mother and the baby. According to American Congress of Obstetrics and Gynelogy (ACOG) 2015, a woman should chose food from all the five food groups such as grains, vegetables, fruits, proteins, and dairy. Oils and fats also provide

nutrients that are energy builders and are also important for fetal organ and placental development.

ACOG (2015) advises the intake of vitamins such as folic acid, vitamin D, vitamin A, iron, omega-3 and calcium during pregnancy. Fish such as shark, swordfish, king mackerel, and tile fish should be consumed during pregnancy due to high mercury contents; tuna fish should be limited to 6 ounces per week to help prevent birth defect. The pregnant patient should avoid food that maybe contaminated with literiosis such as unpasteurized milk, cold processed meats, refrigerated smoked seafood, raw or undercooked eggs, seafood, and meat (ACOG, 2015). There are many challenges that might keep the pregnant client from meeting her nutritional needs in regard to finance socioeconomic. The financial challenge lies in the inability to afford healthy food and vitamins. Moreover, the financially disadvantaged woman might lack in fund to seek prenatal care where she could be educated about her nutritional needs as a pregnant woman. Therefore, she might not know otherwise. Furthermore, there clients who

reside in areas where fresh markets are not conveniently located. These women would have to commute to do grocery shopping. Consequently, if there is available transportation it will be very challenging for them to access nutritious food.
Certain cultural practices pose a challenge to the health of the pregnant woman. Women whose cultural background practice unhealthy nutrition, will most likely continue such habit even during pregnancy. Some cultures believe that certain food should not be consumed during pregnancy and therefore encourage women to refrain from them. For example in some African cultures, women are encourage to refrain from eating avocado, banana, fish, egg, and beef to prevent the fetus from overgrowing (African Populations and Health Research Center, 2014).
In the United States, there are agencies that are available to help pregnant women meet their nutritional needs. The Woman, Infant and Children (WIC) program provides pregnant women with nutritional vouchers to grant them access to free food and nutritional counseling during and after pregnancy based on income level. Another program that is available to many women is the Medicaid program, which pays for the medical care of the pregnant woman and gives her early access to prenatal care and nutritional education. Although these programs are available, nurse practitioners must be aware that not all pregnant women are eligible for such benefits. Illegal immigrants which may account for a large number of patients seen by NP, especially in rural areas and may not be eligible for Medicaid depends on the state in which they reside.
• Breast-feeding is encouraged by almost all medical associations and societies. What does the nurse practitioner say to the female who is:
o Against breast-feeding
The nurse practitioner should talk to the woman and determine her reason for being against breast-feeding. Based on her answer, the NP can educate the patient and encourage her to attempt to breast-feed. The patient must be educated about the benefits of breast feeding, but her concerns must also be taking into considerations.
o Unsure about breast-feeding
The person who is unsure about breast-feeding should also be encouraged to verbalize her uncertainty. These uncertainties shall be addressed, while continuously encourage the patient to try to breast feed. The practitioner should ask the patient, what makes her unsure of breast-feeding. What is keeping her from?
o Confused about breast-feeding
The person who is confused about breast feeding should definitely be educated about breast-feeding. She should be asked about what she knows about breastfeeding; educational materials should be geared towards her lack of knowledge.
• Is it possible for a woman to get pregnant during the time of breast-feeding? Explain your answer.
A woman can get pregnant while she is breastfeeding based on the frequency of feeding. However, frequent breastfeeding causes elevate prolactin which will inhibit the pituitary gland from releasing GnRH, thereby reducing the likelihood of pregnancy. GnRH is responsible for the release of LH and FSH which are necessary for menstruation and ovulation.
• In what ways does teen pregnancy differ from pregnancy in women who are twenty and older?
Teen pregnancy differ in many aspects from women who are twenty and older. According to Neistein (2008), there is one advantage to teen pregnancy in relation to complication during pregnancy and deliveries. Otherwise, pregnant teen face greater issues of abandonment by their partners, lack of family and social support, lack of financial support, increase in drug abuse. Teens usually seek prenatal care later during pregnancy as opposed to those in their twenties or older.