OB Case Study

NURS 331- Child Bearing

Purpose of Assignment
This activity enables the student to conduct an in-depth assessment of a childbearing
woman and her family and plan nursing care specific to that client, based on nursing research
and AWHONN Standards of Care. The assessment will include the physiologic, psychologic,
social, cultural, and environmental influences pertaining to the client and her family.
Student Approach to Assignment
The patient I chose for this case study was a 24 year old female who had a history of
depression. This was her first pregnancy and during labor she failed to progress and had to have
a cesarean section. She had many psychosocial issues because the father of the baby was not in
the picture and her mother was her only support system.
Reason for Inclusion of the Assignment in the Portfolio
This assignment is included in the portfolio because it highlights the care that I gave to a patient
with psychosocial and physical health care needs. This activity enables the student to conduct an
in-depth assessment of a childbearing woman and her family and plan nursing care specific to
that client, based on nursing research and AWHONN Standards of Care. The assessment will
include the physiologic, psychologic, social, cultural, and environmental influences pertaining to
the client and her family.
Critical Thinking
Evaluates nursing care outcomes through the acquisition of data and the questioning of
inconsistencies.
Example: I discussed that through my assessment I found hemorrhoids on the patient
and reported it to the nurse. It was a new finding that was not documented previously.
I recommended putting the protective hemorrhoid cream on the area to prevent them
from becoming larger and becoming painful. I also questioned the nurse on my
findings of crackles in the right lung base. This finding was also not documented and
I asked the nurse to come assess my finding.
Nursing Practice
Applies appropriate knowledge of major health problems to guide nursing practice.
Example: In the current literature section of the paper I used research to back up my
health knowledge of baby blues, postpartum depression, and postpartum psychosis. I
discussed that because this patient had a history of depression, she has an increased
chance of getting postpartum depression and psychosis. I further discussed how I
taught the patient to report any signs of depression immediately in order to get
appropriate help.

 Demonstrates an awareness of complementary modalities and their usefulness in

promoting health.
Example: I demonstrated awareness of complementary modalities and their
usefulness in promoting health by discussing the how I repositioned my patient for
pain relief and taught her about wearing a firm bra to help her milk come in so that
she could breastfeed sooner.
Communication
Produces clear, accurate and relevant writing using correct grammar, spelling and
punctuation.
Example: In this case study, I used headings to organize my thoughts and ideas in a
clear and easy manner for the reader. Each section discussed relevant information
under the appropriate header. Also, I had minimal to none grammar, spelling and
punctuation errors throughout the paper. I also adhered to APA writing style and
guidelines.
Teaching
Provides relevant and sensitive health education information and counseling to patients,
and families, in a variety of situations and settings.
Example: In this case study, I taught both the mother and daughter about signs and
symptoms to report regarding depression to prevent the mother from developing
postpartum depression or psychosis. I also discussed how I taught the patient normal
feelings to have in the baby blue stage postpartum and how long these feelings should
last.
Uses information technologies and other appropriate methods to communicate health
promotion, risk reduction, and disease prevention across the life span.
Example: In this case study I discussed and used research to back up my teaching
regarding the patients risk in developing postpartum depression. I explained how I
discussed with her it was important to seek medical help if she is depressed longer
than three weeks in order to prevent experiencing postpartum psychosis. I also
explained how breast feeding could help her build the mother-baby bond and may
help her feel as though she is providing for her baby.
Research
Evaluates research that focuses on the efficacy and effectiveness of nursing intervention.
Example: In this case study I applied two relevant nursing research articles to the care
for my patient. One of the articles was about to a postpartum depression screening in
order to identify women at risk at an earlier stage of pregnancy based on the Agency
for Healthcare Research and Quality (AHRQ) framework. I explained how although I
did not care for her during her earlier pregnancy, I understand the importance of
screening her post-partum as well because she is such as a high risk for post-partum
depression.

 Professionalism
Understands the effect on legal and regulatory processes on nursing practice and health
care delivery, as well as limits to ones own scope of practice
In this case study I stated that I could not obtain much gynecological health history
due to her mother wanting to be in the room when I did my health history assessment
questionnaire. This information is confidential and because she did not feel
comfortable sharing in front of her mother I had to legally respect this and not obtain
the information. I discussed limits to my scope of practice as a nursing student by
stating I reported my assessment findings and recommendations for care to the nurse
such as the hemorrhoids and hemorrhoid preventative cream use.
Culture
Considers the impact of research outcomes and the effects of health and social policies
on persons from diverse backgrounds
In this case study I discussed findings from a research study that discusses the
importance of initiating screening and detecting women at high risk for depressive
symptoms. The research also found African Americans have a higher percentage than
other races for meeting criteria on the Edinburgh Postnatal Depression Scale, as well
as uneducated women and women with previous history of depressive symptoms.