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This Concept Map has information related to: Michelle Case Study, -Fear related to unknown outcome of birth -Deficient knowledge related to lack of information of problems associated with multiple gestations -Anxiety related to high risk pregnancy and potential complications -Role Strain related to first time mother with twins -Ineffective coping related to her premature babies condition primary diagnosis Anxiety related to high risk pregnancy and potential complications, Anxiety related to high risk pregnancy and potential complications Interventions Adequate Nutrition, I assessed the patient on 9/14/07. Vitals were T: 36.6°C, P: 98, BP: 124/67, R: 18. The patient was alert and oriented. Patient showed no signs of edema, and was negative for homans sign. Patellar reflexes were +2 on right leg, and +3 on left leg. Upon auscultating the lungs, I found they were clear in both lobes, and the patient showed no signs of distress, with even respirations. Bowel sounds were normal and abdomen was soft. The patient was negative for clonus, stated she has no pain, and did not have a headache. The patient reported that her vision was clear. Membranes were still intact and patient did not have vaginal bleeding. When helping the patient up to the bathroom, she showed shortness of breath and stated she was “very tired” after taking a shower. The patient voided 300 ml. The patient experienced no contractions from 0800 to 1200. The fetal heart rates were A: 145, B: 135 with moderate variability and accelerations. Case Study Medications, I noticed that the patient seemed anxious, she complained of lack of sleep and asked the nurse and myself numerous questions about what is normal and how she should feel. She also stated that she was nervous about the birth of the babies, and if “they would be ok if they were born premature”. My patient would have mild to moderate anxiety about the birth of her twins. Goals, Risks For physical Preterm labor, intrauterine growth anomalies, congential anomalies, abnormal presentations, shortness of breath, backaches, pedal edema, prececlampsia, anemia, placenta previa, Multiple Gestations ???? Risks For, Anxiety related to high risk pregnancy and potential complications Interventions Assess level of Anxiey and Emotional Stress, Provides knowledge about the situation that caused the anxiety therefore decreasing the anxiety. The JOGNN stated that information should be given to the patient, stating that stress can cause more potential harm to the fetus. why? Journal Article that supports Interventions, Teaching by: -Provide patient with adequate knowledge about pregnancy -State what is normal and what changes their body is going through -When performing procedures explain what you are looking for or doing -Explain medication function -Explain fetal monitors and how to tell if baby is okay -State changes in fetus as pregnancy progesses -Provide understanding that stress and anxiety can cause harm and promote preterm labor Rationale Provides knowledge about the situation that caused the anxiety therefore decreasing the anxiety. The JOGNN stated that information should be given to the patient, stating that stress can cause more potential harm to the fetus., I noticed that the patient seemed anxious, she complained of lack of sleep and asked the nurse and myself numerous questions about what is normal and how she should feel. She also stated that she was nervous about the birth of the babies, and if “they would be ok if they were born premature”. My patient would have mild to moderate anxiety about the birth of her twins. ???? assess by recognizing symptoms of stress and anxiety