A 20-year-old patient who is at 10 weeks' gestation is preparing ...

[Mollykgkg]

A 20-year-old patient who is at 10 weeks' gestation is preparing for her first prenatal visit. She confides, This pregnancy was unplanned. I'm not sure if I want to be pregnant or not. I haven't even told my boyfriend I'm pregnant.
 
  And I haven't decided if I'm going to continue the pregnancy. Which of the following statements should the nurse make next?
  1. It's really unusual for a pregnant woman to feel this way early in the pregnancy.
  2. These thoughts are because your mother died when you were four years old.
  3. You should go to a pregnancy support group to be a good mother.
  4. It's common to feel ambiguous about pregnancy in the first trimester.

Question 2

A patient at 30 weeks' gestation is tearful at the time of her follow-up visit. She tells the prenatal clinic nurse she is excited to finally become a mother and that she has been thinking about what kind of parent she will be.
 
  However, she is upset because her mother has told her that she doesn't want to be a grandmother because she doesn't feel old enough. Meanwhile, the patient's husband has said that the pregnancy doesn't feel real to him yet and that he will become excited when the baby is actually here. What is the most likely explanation for what is happening within this family?
  1. Her husband will not attach with this child and will not be a good father.
  2. Her mother is rejecting the role of grandparent and will not help out.
  3. The patient is not progressing through the developmental tasks of pregnancy.
  4. Each family member is adjusting to the role change at his own pace.

[lkoler]

Answer to Question 1

Correct Answer: 4
Rationale 1: Fathers might not be told immediately about the diagnosis of pregnancy.
Rationale 2: Loss of the patient's own mother at a young age would not affect the occurrence of ambivalence in the first trimester.
Rationale 3: No psychopathology is present, so a support group is not indicated.
Rationale 4: Ambivalence toward the pregnancy is very common in the first trimester.

Answer to Question 2

Correct Answer: 4
Rationale 1: The husband's statement is quite common. Partners often feel that a pregnancy isn't real to them because they are not experiencing any of the physical changes associated with pregnancy.
Rationale 2: Adaptation to the role of grandparent is another life task that takes time. Younger grandparents often have busy and full lives and view grandparenthood as a time for elderly people who are retired and slowed down. The family will form a view of grandparenthood within this family, in a way that works for them.
Rationale 3: This is a false statement. The patient is at the stage of seeking acceptance of this child by others, which first will be her partner and other family members.
Rationale 4: This is a true statement. When the other family members are at different stages of adjustment to the pregnancy, conflict can ensue.

[Mollykgkg]

Thank you

[lkoler]

Happy to help you