Teaching plan: Management of Pre-term Birth

This paper entails a discussion and development of a nursing teaching plan for the management of pre-term birth. You should begin with a description of the patient followed with teaching plan.

Management of Pre-term Birth

A 34 weeks pregnant female who is 26- years old came into the hospital complaining of having pain and burning feeling when urinating.  She stated that she’s having pain or pressure in her lower abdomen and feeling tired and shaky. On arrival noted to have severe range in blood pressure and an increased in heart rate with fever and chills and diagnose with Urinary tract infection. A few hours later she gives birth to a baby boy born at 28 weeks 3 days. After stabilizing the patient, she was sent up to the post-partum unit.

The patient is worried and has shown a high level of concern for her baby. She thinks that that the baby will die since he had not reached the full-term of 37 weeks. According to her a significant number of children born pre-term are likely to die. Also, the fact that she had a urinary tract infection further intensifies her worries since she is certain the infection will affect further the health of the child. The patient is also blaming herself for the pre-term birth and the low child weight. She believes that if she had eaten properly and taken proper care of herself she would have not gone into pre-term labor leading to pre-term birth of the baby.

Her worries were escalated by the fact that she was young and was a primigravida thus did not understand many issues on matter pregnancy and delivery. Also, the patient was not married and had no parents thus did not have an immediate support system. She was really anxious of the outcome and concerned on how she will manage the situation and ensure her child survives.

My role as the nurse is to assure the patient that the pre-term baby can still survive and leave when proper care is provided. Also, I had the role of educating her to make her understand the reasons for pre-term birth so as to avoid such occurrence and to ensure she is at peace with herself. From her worries and the many questions she presented, it was certain that she did not understand the factors leading to pre-term birth and the issue of intrauterine growth restrictions. Failure to understand the situation leads to many worries that can develop into post-partum depression if not addressed, justifying the need for the teaching session.

My teachings focused on the pre-term birth, the possible causes, complications of pre-term delivery and the care that can be provided to ensure the child remain healthy as other normal kids.

I began by informing her risk factors of pre-term birth and mentioned infections as one of the major issues that may result into a pre-term labor and birth. I also informed her that chronic conditions such as high blood pressures and diabetes are also significant risk factors for pre-term birth (Medley, Poljak, Mammarella & Alfirevic, 2018). I also mentioned other factors such as history of pre-mature birth, stress, and smoking, being underweight or overweight and multiple abortions and miscarriages as factors that can result in pre-term birth.

I also educated the patient on the complications that might occur following a pre-term birth. I informed her that there are three categories of pre-term birth depending on how early the birth occurs. This included

  • Late pre-term- Between 34-36 weeks
  • Moderate pre-term-Between 32-34 weeks
  • Very pre-term-Less than 32 weeks
  • Extremely pre-term-Below 25 weeks

I informed the patient that the risk of death was high for extremely pre-term babies and reduces and the number of months increase. I also educated on other health complications that might occur in pre-term babies in the event that they survive. Short-term complications such as breathing problems, heart problems, metabolism, gastrointestinal and brain problems can be reported, though most of these issues can be addressed as the child develops (Reddy et al., 2015). Long-term problems that most occur in very extreme case of pre-term births such as cerebral palsy, vision problems, development delays and impaired learning may not be resolved and the parent have to learn ways of dealing with the situation in the event that they occur.

Based on the case of a pre-term birth at 34 week, I informed the patient that the chances of survival for the child are high. However, I informed her that the child could develop short-term complications and thus needed maximum care to be healthy. Apart from letting the child stay in the neonatal intensive care unit until she stabilizes, she also had a role to play in the provision. Pre-term babies needs extra care and support in their feeding, warmth and protection from external dangers.

I encouraged the mother to only offer breast milk to the baby since it’s the best source of nutrients for the pre-term babies. In the event that the baby has feeding problems than the milk should be given using nasogastric tubes (Medley, Poljak, Mammarella & Alfirevic, 2018). I also informed the mother to focus on hygiene and always keep the baby warm to avoid any possible infections. A constant check on the breathing rhythm of the baby is also encouraged since its essential in determining whether the baby desires additional ventilation or assistance breathing.

At the end of the teaching process, the patient was ready to be involved in the provision of maximum care to the baby. She was also positive having understood the issue at hand and was encouraged that the child may survive. She even asked for preventive measures that she needs to undertake in case of her next pregnancy. My response was that she treats all infections during pregnancy, and manages her blood pressure, since they are the major risks factors in her case.

The teachings gave the patient the motivation to offer maximum care to the pre-term baby and the hope that her child will survive.

 

 

 

 

 

 

 

 

 

 

 

 

 

References

Medley, N., Poljak, B., Mammarella, S., & Alfirevic, Z. (2018). Clinical guidelines for prevention and management of preterm birth: a systematic review. BJOG: An International Journal of Obstetrics & Gynaecology125(11), 1361-1369.

Medley, N., Poljak, B., Mammarella, S., & Alfirevic, Z. (2018). Clinical guidelines for prevention and management of preterm birth: a systematic review. BJOG: An International Journal of Obstetrics & Gynaecology125(11), 1361-1369.

Reddy, U. M., Rice, M. M., Grobman, W. A., Bailit, J. L., Wapner, R. J., Varner, M. W., … & Tita, A. T. (2015). Serious maternal complications after early preterm delivery (24-33 weeks’ gestation). American journal of obstetrics and gynecology213(4), 538-e1.