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CUES A 27-year old mother of 2 at 6 weeks AOG, (G3P2- 320020) with a hx of 2 CS deliveries, ht. 410 (147 cm), wt.

142 lbs (64.5 kg). She verbalized, baka cesarean uli ako, kasi sabi ni dok, maliit daw yung sipit-sipitan ko, cesarean din yung 2 kong unang anak nasa lahi yata namin. She professed no knowledge about the risks/complications to her and her child of a repeat cesarean (especially now that shes on her third possible CS). She has irregular menstruation cycle, got pregnant at age 19. She said that current pregnancy is unplanned. She used contraceptives before based on a friends advice but havent ever consulted a doctor to discuss about family planning or her reproductive health issues. She stopped using the pills as she believes that she doesnt need them saying di naman ako madaing mabuntis.

FAMILY NURSING PROBLEMS Possible complicated/ high-risk pregnancy - Inability to recognize presence of potential complications of her pregnancy and possible repeat cesarean due to lack of knowledge a. Lack of knowledge on the nature and management of her health condition b. Lack of knowledge on the nature and extent of nursing care she needs - Stress-provoking factors including: a. Strained marital relationship b. Interpersonal relationship with her family-in-laws. - Unhealthy nutrition, lifestyle, and personal habits/practices a. Imbalanced nutrition b. Smoking history and passive smoking c. Occasional drinking d. Sedentary lifestyle

GOAL OF CARE After SNs home visits (1 week), the mother will verbalize understanding of the necessary measures to prevent or properly managed possible complications of her pregnancy

OBJECTIVES OF CARE After nursing intervention, the mother will: a. Ensure that she will have a regular prenatal check-up at the center/ clinic. b. Implement agreedupon health actions in the areas of laboratory work-up, nutrition/diet, physical activity, rest and sleep, and general hygiene. c. Decide on a hospital delivery d. Explore the couples ways of encouraging growth-promoting activities, relationship problems, issues and concerns. e. Be encouraged together with his husband to be referred to a marital relationship counselor.

INTERVENTION PLAN Method of Nursing Interventions Nurse-Family Contact 1. Broaden the Home visits knowledge of the family on complications of pregnancy, especially of an impending repeat cesarean delivery rd (3 CS operation) a. Discuss the implications of previous CS operations on current pregnancy, and occurrence of signs and symptoms as they will be presented by Ms. R.G. b. Discuss the consequence of failure to take appropriate actions 2. Discuss with the mother the courses of action open to her, and the consequences of the their health actions on her, her baby and her family

Resources Required Material resources: Visual aids, VS and PE equipment. Time and effort of the SNs and the mother Transportation expenses, and food of the SNs and the mother.

Although she is currently not smoking, the mother reported that she was smoking prior to learning about her pregnancy (Smoking hx of X sticks/day for X years. She is also exposed to nd 2 -hand cigarette smoke due to her husband who smokes >1 pack/day for X years. Last laboratory test was undertaken 4 years ago. She claims that she feels okay, and doesnt seem bothered by her possible third cesarean delivery. She loves to eat meat viands such as adobo, nilaga, sinigang, but rarely prepares vegetables nor eats fruits except for banana. She likes drinking soda with meals. She also is not used to doing physical exercise, and admits to not having enough quality sleep. She expressed concerns about husbands infidelity issues, and has gotten involved in fights with him that sometimes lead to physical violence. She admits that her greatest stressor right now is her husband and misunderstanding with family-in-laws.

e.

Lack of quality/ adequate sleep