WEEK 8: ACTIVITY (CASE SCENARIO)
Pregnancy Case Study 1
A 36-year-old female comes in for her 16-week prenatal visit. She has been suffering from hyperemesis since her sixth week,
and while it has begun to get better, she still vomits three to four times a day. Her nausea is alleviated somewhat by sipping on Coke
and sucking on ginger candies. She has not been to the dentist in the past year, and she has not been able to regularly brush her
teeth since the onset of hyperemesis, because the toothbrush in her mouth triggers vomiting. She reports pain when drinking hot
tea or cold ice cream.
NURSING DIAGNOSIS GOAL INTERVENTION RATIONALE EVALUATION
Impaired dentition r/t Within 30 minutes to 1 INDEPENDENT: Goal met: The patient
insufficient oral hygiene hour of medical-nursing was able to display the
as evidenced by the intervention. The client 1. Assess the patient’s - Oral hygiene ability to care for their
pain when drinking hot will be able to: oral hygiene information own teeth and mouth
tea or cold ice cream. practices. provides direction freely and individually
● Have clean teeth on possible as evidenced by daily
and healthy pink etiological factors the routine of brushing
gums. and guidance for and flossing and using
● Explain how to subsequent mouthwash and
perform oral education. fluoridation properly.
care.
● State free of 2. Educate the patient - Right knowledge
pain in mouth about the helps prevent
importance of oral possible dental
hygiene. problems.
3. Assess the patient’s - Poor food choices
nutritional status. contribute to
dentition problems.
Email: cn@usa.edu.ph | Tel. No.: 0999-997-1485 | Fax No.: (033) 337-4403
Poor dentition can
affect food
consumption with
people with loss of
teeth consuming
fewer foods rich in
fiber such as fruits
and vegetables.
4. Provide a mouth - Cleaning of teeth
care routine with a toothbrush
including and
toothbrushing at fluoride-containing
regular intervals toothpaste prevents
with a soft-bristle the build-up of
toothbrush and plaque.
fluoride toothpaste.
5. Instruct the patient - These measures
to rinse the mouth help promote oral
with warm saline or hygiene.
an antiplaque
mouth rinse.
6. Encourage them to - High-sugar foods
avoid high-sugar may cause tooth
foods. decay and promotes
good oral health
and healing.
Email: cn@usa.edu.ph | Tel. No.: 0999-997-1485 | Fax No.: (033) 337-4403
7. Educate the patient - Checkups help
regarding the identify dental
importance of problems early.
dental checkups and
follow-ups.
INTERDEPENDENT:
1. Refer to a dentist or - If the lesion is
periodontist as cancerous, prompt
appropriate. treatment is
needed.
NURSING DIAGNOSIS GOAL INTERVENTION RATIONALE EVALUATION
Nausea r/t hormonal Within 30 minutes to 1 1. Provide an emesis - Nausea and Goal Partially Met: The
changes of pregnancy hour of medical-nursing basin within easy vomiting are closely patient was able to
as evidenced by intervention. The client reach of the patient. related. Keep the report the decreased
hyperemesis since her will be able to: emesis basin out of severity or elimination
sixth week of pregnancy sight but within the of nausea.
and vomits for three to ● State relief of patient’s reach if
four times a day. nausea nausea has a
● Use the psychogenic
methods to component.
decrease nausea
and vomiting. 2. Educate and assist - This is associated
patients with oral with anorexia and
hygiene. excessive salivation.
Oral hygiene helps
Email: cn@usa.edu.ph | Tel. No.: 0999-997-1485 | Fax No.: (033) 337-4403
to alleviate the
condition and
facilitate comfort.
3. Maintain fluid - Sufficient hydration
balance in patients before surgery or
at risk. chemotherapy has
been shown to
reduce the risk of
nausea in these
situations.
4. Tell the patient to - Strong and noxious
avoid foods and odors can
smells that trigger contribute to
nausea. nausea.
5. Educate the patient - Patients and
about appropriate caregivers can
fluid and dietary promote adequate
options for nausea hydration and
nutritional status by
acknowledging
dietary points to
consider when
nauseated.
6. Inform the patient - Persistent vomiting
to seek medical care can result in
if vomiting develops dehydration,
Email: cn@usa.edu.ph | Tel. No.: 0999-997-1485 | Fax No.: (033) 337-4403
or persists longer electrolyte
than 24 hours. imbalance, and
nutritional
deficiencies.
Pregnancy Case Study 2
A 28-year-old woman comes in for her 32-week prenatal visit. She was recently diagnosed with gestational diabetes so is
trying to change her diet, but was previously eating a lot of carbohydrates and sugary snacks. She reports bleeding while brushing
her teeth, pain with eating, and a feeling that a few of her teeth are “wiggling.” She has not been to the dentist in a few years and
intended to go when the bleeding started a few months ago, but a friend told her it wasn’t safe to get a cleaning during pregnancy.
NURSING DIAGNOSIS GOAL INTERVENTION RATIONALE EVALUATION
Readiness for enhanced Within 30 minutes to 1 INDEPENDENT: Goal Met: The patient
nutrition secondary to hour of medical-nursing was able to follows the
gestational diabetes r/t intervention. The client 1. Assess the meaning - Research findings prescribed dietary
excessive weight gain as will be able to: and importance of demonstrate that intake appropriately
evidenced by the food in the client’s implicit attitudes and identifies the
patient eating a lot of ● Show life. significantly predict proper food and fluid
carbohydrates and appropriate purchases of choices for her diet.
sugary snacks. meal selection. healthy and
● Verbalize the unhealthy foods.
benefits of
adopting healthy 2. Demonstrate the - The standardized
eating habits. use of food labels to food label in bold
● Maintain weight make healthful type simplifies the
within the choices. Alert the search for
normal range. client/family to information. Fats
● Gain at least focus on serving and sugars
Email: cn@usa.edu.ph | Tel. No.: 0999-997-1485 | Fax No.: (033) 337-4403
25-30 lbs size, total fat, and contribute the least
prenatally or as simple to a healthful diet
appropriate for carbohydrate. and the most to
pre-pregnancy excessive calorie
weight. intake.
3. Recommend the - Intake of whole
client eat whole grains has been
grains whenever shown to decrease
possible, and the incidence of
explain how to find heart failure and,
whole grains using when eaten with
the food label. other healthier
foods, resulted in a
lower incidence of
diabetes in a
multiethnic study
4. Instruct the client - Carbohydrate
about proper restriction remains
carbohydrate the most common
restriction. approach for
medical nutrition
therapy in GDM.
5. Encourage the client - Added sugar usually
to decrease the adds calories but no
amount of added valuable nutrients.
sugars, including
soft drinks.
Email: cn@usa.edu.ph | Tel. No.: 0999-997-1485 | Fax No.: (033) 337-4403
6. Teach the patient - Food labels provide
how to identify information about
healthy food from the amount of
food packages. certain nutrients
and the serving size
of a specific food.
INTERDEPENDENT:
1. Refer to a dietician - A dietician can
for an individualized provide an optimum
diet plan and nutrition plan for
counsel dietary the client.
questions.
Email: cn@usa.edu.ph | Tel. No.: 0999-997-1485 | Fax No.: (033) 337-4403
