Case study # 11

1. Jessica and Mike are new clients at your obstetrics office. You are asking them about the reason for their visit. Jessica says she thinks she is pregnant because she missed a period. Mike tells you Jessica is always nauseated in the morning and eats all the time the rest of the day. They have not been using birth control and have wanted to have children since they got married last summer. Jessica says her clothes are feeling tighter and her breasts seem tender. Mike says he has noticed that Jessica has been frequently getting up to go to the bathroom at night. (Learning Objectives 1 and 3)

• What subjective symptoms have led Jessica and Mike to presume she is pregnant? What other conditions could be the cause of Jessica’s symptoms? How can a pregnancy be confirmed as probable? Diagnosed as positive?
• What are the nutritional needs of Jessica and her baby?

2. Beth (age 18) is experiencing her first pregnancy and is now 24 weeks gestation. She tells you that she is “amazed by the changes that have happened to my body already.” Beth wants to understand what additional changes are going to occur to her “besides just getting a really huge belly.” Additionally, Beth relates to you that she is in her senior year of high school, is no longer involved with the baby’s father, and lives at home with her mother and 12-year-old brother. (Learning Objectives 2 and 4)

• What general body adaptations will Beth experience throughout the remainder of her pregnancy?
• What psychosocial adaptations may Beth experience as a result of being a teenage, single mother living at home?

Chapter 8, Cancers of the Female Reproductive Tract

1.The nurse educator has been asked by a local women’s cancer support group to speak with their daughters and granddaughters about cervical cancer. (Learning Objectives 1, 2, 3, and 4)

• What are the identified risk factors for cervical cancer? What can be done to decrease the risk for development of cervical cancer?
• What screening test should women have, and how often, for cervical cancer? Does this change with age?
• Once a woman is diagnosed with cervical cancer, what are the treatment options?
• What is the most common cancer of the reproductive tract? What can be done to decrease the risk factors for all female cancers?

2. Janet is a 67-year-old Caucasian client coming to your office today to receive her test results after being seen a week ago for complaints of pelvic and abdominal discomfort, urinary frequency and urgency, and abdominal bloating despite not eating much. You are in the room with Janet when her doctor enters the room and gives Janet the diagnosis of probable ovarian cancer. He wants to schedule surgery immediately. He leaves you and Janet to discuss the situation and come up with a decision regarding immediate surgery. Janet is stunned and has a lot of questions. (Learning Objectives 2, 3, and 6)

• Janet wants to know how she got ovarian cancer. How would you explain the etiology to Janet in terms she can understand?
• Janet wants to know what this means. Janet asks “Am I going to die from this?” What are the treatment options and prognosis for ovarian cancer to Janet?
• As the nurse caring for Janet, how can you support her and her family as they journey through this event?