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- After hearing this information, should Sue and Tim feel that their chances of having a child with a cleft lip are increased over that of the general population? Sue and Tim were referred for genetic counseling after they inquired about the risk of having a child with a cleft lip. Tim was born with a mild cleft lip that was surgically repaired. He expressed concern that his future children could be at risk for a more severe form of clefting. Sue was in her 12th week of pregnancy, and both were anxious about the pregnancy because Sue had had a difficult time conceiving. The couple stated that they would not consider terminating the pregnancy for any reason but wanted to be prepared for the possibility of having a child with a birth defect. The genetic counselor took a three-generation family history from both Sue and Tim and found that Tim was the only person to have had a cleft lip. Sues family history showed no cases of cleft lip. Tim and Sue had several misconceptions about clefting, and the genetic counselor spent time explaining how cleft lips occur and some of the known causes of this birth defect. The following list summarizes the counselors discussion with the couple. Fathers, as well as mothers, can pass on genes that cause clefting. Some clefts are caused by environmental factors, meaning that the condition didnt come from the father or the mother. One child in 33 is born with some sort of birth defect. One in 700 is born with a cleft-related birth defect. Most clefts occur in boys; however, a girl can be born with a cleft. If a person (male or female) is born with a cleft, the chances of that person having a child with a cleft, given no other obvious factor, is 7 in 100. Some clefts are related to identifiable syndromes. Of those, some are autosomal dominant. A person with an autosomal dominant gene has a 50% probability of passing the gene to an offspring. Many clefts run in families even when there does not seem to be any identifiable syndrome present. Clefting seems to be related to ethnicity, occurring most often among Asians, Latinos, and Native Americans (1 : 500); next most often among persons of European ethnicity (1 : 700); and least often among persons of African origin (1 : 1,000). A cleft condition develops during the fourth to the eighth week of pregnancy. After that critical period, nothing the mother does can cause a cleft. Sometimes a cleft develops even before the mother is aware that she is pregnant. Women who smoke are twice as likely to give birth to a child with a cleft. Women who ingest large quantities of vitamin A or low quantities of folic acid are more likely to have children with a cleft. In about 70% of cases, the fetal face is clearly visible using ultrasound. Facial disorders have been detected at the 15th gestational week of pregnancy. Ultrasound can be precise and reliable in diagnosing fetal craniofacial conditions.As the nurse working on a postpartum unit, you are caring for John and Janah, who have just become parents of a 7 lb and 2 oz baby boy. As you prepare them for discharge, you notice that they seem overwhelmed with much of the information being provided. Janah says, “ Maybe my breasts are too small and the baby can’t get enough milk.” She added, “I am hoping that if I breastfeed, I won’t have to worry about birth control for a while.” GUIDE QUESTIONS: The couple needs health teaching in a number of areas. Which subject would you begin with? Why? Explain how breastfeeding can prevent pregnancy? How can you best explain this to the couple?Brenna's pregnancy and delivery went even better than she'd expected. She had zero complications, and even with the birth of twins, she felt she was recovering well. The real challenge came when it was time to breastfeed her twins, Silvia and Lynette. Breastfeeding for the first time can be a challenge for any mom, and breastfeeding twins can be double the challenge. Brenna is having major concerns about being able to produce enough milk. Brenna is a small-breasted woman, and she is worried that she will not be able to feed both of her babies. True or false: Brenna will produce enough milk as long as her babies continue to nurse and stimulate production. The size of her breasts does not affect production, but it does affect the amount of milk she can store.
- Mr. and Mrs. Smith have arrived for their first fertility appointment after trying unsuccessfully to get pregnant for the past year. Mrs. Smith is withdrawn, her voice is monotone, and she becomes tearful when the nurse begins to take a health history. Mr. Smith hugs her and holds her hand, but Mrs. Smith doesn't seem to notice. What is the best nursing action to take at this time? O Get a box of tissues and encourage Mrs. Smith to discuss what she's feeling. O Ask Mr. Smith to leave the room and ask Mrs. Smith if she feels safe at home and how long she's been abused. O Tell Mrs. Smith she's being silly; the clinic will make everything better. O Continue taking the history; this is just part of the job.Mrs. Vanessa Narciso has a prenatal weight of 105 and weighs 108 lb at her 12 week visitWhich of the following comments by Nurse Marina is appropriate at this time ? a. "We expect you to gain 1lb per week so your weight is a little low at this time” b. “You entered the pregnancy well underweight, so we should check your diet to make sure you are getting nutrients you need” c. “Your weight gain is exactly what we would expect at this time” d. “Most women gain no weight during the first trimester, so I would suggest you to eat fewer desserts for the next few weeks”A young woman is seen in the emergency department. She states, "I took a pregnancy test today . I'm pregnant . My parents will be furious with me !! have to do somethingWhich of the following responses by the nurse is most appropriate? Lets talk about your options Take medicine to abort the pregnancy so your parents won't know. I can help you tell your parents The best thing for you to do is to have the baby and to give it up for adoption.
- Let’s pretend that you are a Dietician, and a client or patient approached you for advice on healthy eating during her pregnancy. Explain the changes in nutrients needs that occur to support pregnancy and provide some helpful advice about fish consumption to your patient.Leslie, 17, mother of 2-week-old Milton, is a single mother who is new to your community. Milton's father left Leslie during her pregnancy while they were both in drug rehab, and she does not have any contact with her family. You are the support worker assigned to Leslie after a public health nurse reported that Leslie had troubles bathing and feeding Milton and adjusting to her new role as a mother. You are to report any concerns to your supervisor. Leslie is currently breastfeeding Milton. Milton weighed 3.6 kg (8 lb.) at birth and, according to his pediatrician, has grown and gained weight well. On the two last visits, Leslie seemed to have no trouble changing him, bathing him, or knowing when to bring him to his doctor for weekly visits. On your visit today, Leslie greets you at the door, carrying Milton in one arm and holding a cigarette in her other hand. She looks as if she has been crying. Milton is crying, wet, and obviously needs a diaper change. Leslie says that she thinks…A client comes to the clinic because she thinks she might get pregnant, her pregnancy test show positive and she is 10 weeks pregnant. This is the client first pregnancy. She is asking many questions about what to to expect ,especially in the area of nutrition and weight gain?
- Leslie, 17, mother of 2-week-old Milton, is a single mother who is new to your community. Milton's father left Leslie during her pregnancy while they were both in drug rehab, and she does not have any contact with her family. You are the support worker assigned to Leslie after a public health nurse reported that Leslie had troubles bathing and feeding Milton and adjusting to her new role as a mother. You are to report any concerns to your supervisor. Leslie is currently breastfeeding Milton. Milton weighed 3.6 kg (8 lb.) at birth and, according to his pediatrician, has grown and gained weight well. On the two last visits, Leslie seemed to have no trouble changing him, bathing him, or knowing when to bring him to his doctor for weekly visits. On your visit today, Leslie greets you at the door, carrying Milton in one arm and holding a cigarette in her other hand. She looks as if she has been crying. Milton is crying, wet, and obviously needs a diaper change. Leslie says that she thinks…A) You have been tasked to prepare for a script for a radio talk show on benefits of breast feeding to the infant and mother during the world breastfeeding week. Clearly highlight the key messages you would communicate to the mothers B) Explain the strategies you would implement to protect, promote and support breastfeeding among the refugee populationElsa is a mother of 2 and currently on her first trimester of her 3rd pregnancy's. She loves to eat raw rice, unripe guava and other unique food. Her two children ages 2 years and 3 years is remarkably stunted for growth, pale and big tummy, you have visited her home as part of your family nursing care. Based on this scenario to whom would you refer the family.