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Author Question: The lesbian woman who is pregnant by in vitro fertilization from an unknown donor comes to the ... (Read 52 times)

yoroshambo

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The lesbian woman who is pregnant by in vitro fertilization from an unknown donor comes to the obstetric clinic in her seventh month with her partner.
 
  When asked by the nurse why she has waited so long to come in, the patient remarks, Oh, you know why.. The nurse suspects that this patient is: 1. Experiencing a fear of discrimination on the part of providers.
  2. Without insurance, and is afraid she will be turned away.
  3. In good health, and did not need to come in any sooner.
  4. Independent in her health care, and opted for self-care until now.

Question 2

A 21-year-old at 12 weeks' gestation with her first baby has known cardiac disease, class III, as a result of childhood rheumatic fever. During a prenatal visit, the nurse reviews the signs of cardiac decompensation with her.
 
  The nurse will know that the patient understands these signs and symptoms if she states, I would notify my doctor if I had: 1. A pulse rate increase of 10 beats per minute.
  2. Breast tenderness.
  3. Mild ankle edema.
  4. A frequent cough.



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yuyiding

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Answer to Question 1

1
Rationale 1: The woman most likely has a fear of discrimination due to her sexual status. This is a very real fear, as health providers are often ignorant concerning gays and lesbians.
Rationale 2: This might be true, but it is less likely that a lack of health insurance would prevent a pregnant woman from seeking health care than that another reason would.
Rationale 3: The woman might be in good health, but that does not mean she should postpone seeking health care until later in her pregnancy.
Rationale 4: The woman might be independent, but that is not likely to prevent her from seeking health care early in her pregnancy.

Answer to Question 2

4
Rationale 1: In most pregnant patients , the heart rate will increase.
Rationale 2: Most pregnant patients will develop breast tenderness.
Rationale 3: The patient with rheumatic heart disease who develops congestive heart failure would have severe ankle edema.
Rationale 4: With the increased workload of the heart with pregnancy and the increase in blood volume, this patient is at risk for developing congestive heart failure. This would result in the frequent cough.





 

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