Situational Analysis (May 5,2020)

Michelle D. Marquez

What information should the nurse provide Adrienne?

1.Evidence:

As a nurse educate Ms. Adrienne the Pregnancy week by week, Pregnancy weeks are grouped into
three trimesters, each one with medical milestones for both you and the baby. In First trimester,A baby
grows rapidly during the first trimester (weeks 1 to 12). The fetus begins developing their brain, spinal
cord, and organs. The baby’s heart will also begin to beat. During the first trimester, the probability of a
miscarriage is relatively high. According to the American College of Obstetricians and Gynecologists
(ACOG), it’s estimated that about 1 in 10 pregnancies end in miscarriage, and that about 85 percent of
these occur in the first trimester. Seek immediate help if you experience the symptoms of miscarriage.
Second trimester, During the second trimester of pregnancy (weeks 13 to 27), your healthcare provider
will likely perform an anatomy scan ultrasound. This test checks the fetus’s body for any developmental
abnormalities. The test results can also reveal the sex of your baby, if you wish to find out before the
baby is born. You’ll probably begin to feel your baby move, kick, and punch inside of your uterus. After
23 weeks, a baby in utero is considered “viable.” This means that it could survive living outside of your
womb. Babies born this early often have serious medical issues. Your baby has a much better chance of
being born healthy the longer you are able to carry the pregnancy. Third trimester, During the third
trimester (weeks 28 to 40), your weight gain will accelerate, and you may feel more tired. Your baby can
now sense light as well as open and close their eyes. Their bones are also formed. As labor approaches,
you may feel pelvic discomfort, and your feet may swell. Contractions that don’t lead to labor, known as
Braxton-Hicks contractions, may start to occur in the weeks before you deliver.

2.Assumptions

a. Adrienne's motivation to learn about fetal development

Pre-Pregnancy and prenatal care can help prevent complications and inform women about important
steps they can take to protect their infant and ensure a healthy pregnancy. With regular prenatal care
women can: Reduce the fetus's and infant's risk for complications.

b.Adriennne's understanding of fetal development

Each month, your body goes through a reproductive cycle that can end in one of two ways. You will
either have a menstrual period or become pregnant. This cycle is continuously happening during your
reproductive years—from puberty in your teen years to menopause around age 50.

In a cycle that ends with pregnancy, there are several steps. First, a group of eggs (called oocytes) gets
ready to leave the ovary for ovulation (release of the egg). The eggs develop in small, fluid-filled cysts
called follicles. Think of these follicles as small containers for each immature egg. Out of this group of
eggs, one will become mature and continue on through the cycle. This follicle then suppresses all the
other follicles in the group. The other follicles stop growing at this point.

The mature follicle now opens and releases the egg from the ovary. This is ovulation. Ovulation generally
happens about two weeks before your next menstrual period begins. It’s generally in the middle of your
cycle.

After ovulation, the opened (ruptured) follicle develops into a structure called the corpus luteum.

This secretes (releases) the hormones progesterone and estrogen. The progesterone helps prepare the
endometrium (lining of the uterus). This lining, is the place where a fertilized egg settles to develop. If
you don’t become pregnant during a cycle, this lining is what is shed during your period.

average, fertilization happens about two weeks after your last menstrual period. When the sperm
penetrates the egg, changes occur in the protein coating of the egg to prevent other sperm from
entering.

At the moment of fertilization, your baby’s genetic make-up is complete, including its sex. The gender of
your baby depends on what sperm fertilizes the egg at the moment of conception. Generally, women
have a genetic combination of XX and men have XY. As the mother, you provide each egg with an X.
Each sperm can be either an X or a Y. If the fertilized egg and sperm is a combination of an X and Y, it’s a
boy. If there are two Xs, it’s a girl.

c.Adrienne's knowledge about ultrasound examinations?

Ultrasonography uses high-frequency sound (ultrasound) waves to produce images of internal organs
and other tissues. A device called a transducer converts electrical current into sound waves, which are
sent into the body’s tissues. Sound waves bounce off structures in the body and are reflected back to
the transducer, which converts the waves into electrical signals. A computer converts the pattern of
electrical signals into an image, which is displayed on a monitor and recorded as a digital computer
image. No x-rays are used, so there is no radiation exposure during an ultrasonography.
Ultrasonography is painless, relatively inexpensive, and considered very safe, even during pregnancy.

Pregnancy ultrasound involves an anatomic survey of uterus and adnexa. On the initial ultrasound, it is
important to establish the location of the gestational sac, confirm the intrauterine location and
document the presence or absence of yolk sac, fetal pole, and fetal number. If a fetal pole is seen, the
presence of fetal heart tones should be documented. If ultrasound is performed beyond 18 weeks of
gestation, a full fetal anatomic survey is possible.

d.Why dating the pregnancy is important

The most important step in the initial evaluation of any pregnant patient is establishing an accurate
delivery date (due date). Accurate knowledge of the gestational age is important for numerous reasons.
A patient’s gestational age determines the appropriate intervals for prenatal care visits, as well as the
timing of certain interventions.
3.What implications and priorities for nursing care can be drawn at this time?

Nurses can act as advocates and educators, creating healthy, supportive communities for women and
their partners in the childbearing phases of their lives. It is important to enter into a collaborative
partnership with the woman and her partner, enabling them to examine their own health and its
influence on the health of their future baby. Provide information to allow the woman and her partner to
make an informed decision about having a baby, but keep in mind that this decision rests solely with the
couple.

4.Does the evidence objectively support your conclusion?

Yes, because of the given situation and conclusion that found after answering the questions.

5.Are there alternative perspectives to your conclusion?

No, because the evidence is clear.