Module Test 1:

1. Discuss the advantages of preconception care and counselling for a woman and her spouse who
are planning to have a baby.

Preconception care and counselling presents numerous advantages to both the woman and her
spouse. Initially it provides them with an accurate diagnosis of their capability to conceive and
carry a pregnancy. In the case that they are assessed to have a certain difficulty, they can be
provided with choices of treatment or a choice of not pursuing the pregnancy at all. In knowing
their prospects, they can therefore be guided accordingly based on the decision they wish to
pursue. Not only are they provided with knowledge, guidance and a range of choices,
preconception care will also endeavor to smooth out the process of conception and pregnancy
by optimizing both man and womans health as well as their physical environment in
preparation for the pregnancy. Ultimately, the advantage of such care is that it will help to
secure successful pregnancy and childbirth.

2. Discuss fully the importance of immunization to a pregnant woman. What are the
immunizations which are very necessary for her and lay out the schedule of the immunizations
to be given? Discuss too the immunizations contraindicated in pregnancy.

Vaccinations can help protect both the mother and the unborn child from certain infections during
pregnancy. Vaccinations given to the mother during pregnancy passes on some degree of immunity to
the newborn during the first few months of life until the child can get his own vaccinations. Among the
recommended vaccinations that a pregnant woman should have are the following to be given according
to a prescribed schedule.

VACCINE NO. OF DOSES SCHEDULE

Tetanus toxoid 3 doses including First dose: Early in pregnancy

booster dose
Second dose: Four weeks after first dose

Third dose: On succeeding pregnancy occurring with 3 years from the last
dose or 6 months from the last dose

Influenza One dose yearly During any trimester

Hepatitis B 3 doses Given at 0, 1, 6 months

The live attenuated vaccines such as influenza nasal spray, measles, mumps, rubella, varicella and BCG
are contraindicated during pregnancy because of theoretical concerns that they may increase the risk of
malformations, congenital rubella syndrome, or varicella syndrome attributable to these vaccines. The
hepatitis b and tetanus vaccines on the other hand, are composed of noninfectious particles or toxoids,
and theoretically should cause no increased risk to the developing fetus.
 3. Low birth weight and congenital anomalies are two of the most common problems on which
prenatal care has had little impact in the past how many decades. Explain how preconception
care can reduce the incidence off these two problems.

Preconception care can very well help to reduce the incidence of low birth weight and congenital
anomalies among newborns by guiding the couple in implementing certain lifestyle changes and health
measures such as proper nutrition; regular prenatal checkups and smoking, illicit drug and alcohol
abuse cessation. It also prepares the expectant mother through adequate advise on how to
prevent infections that could otherwise cause malformations in the developing fetus. During
preconception care, advice is also given on how to manage pre-existing illnesses to prevent it
from interfering with the optimal development of the child.

4. Situation:
A woman employed in a company, 6 months pregnant for the first time and is presently
experiencing many physiologic discomforts. She is at risk of food/water poisoning and
toxic waste hazards. She is also under treatment of a sexually transmitted disease.
a. As a nurse, do you think the pregnant woman should take a leave from her work
until she gives birth? Support your answer.

Yes, I believe the pregnant woman should take a leave from her work, at least for the duration of her
pregnancy in order to safeguard the pregnancy. The workplace itself poses various environmental
hazards, that, although may not directly harm the fetus, can affect the health of the mother adversely
and can put a strain on the mothers body. With the increased demands of pregnancy, the mothers
immunity and resistance against other external stressors is compromised thereby predisposing her to
succumb to such added physiologic stressors such as toxic waste hazards and the possibility of food and
water poisoning.

Moreover, the mother has also been experiencing many physiologic discomforts which indicates that
her work, and workplace, could possibly be causing such. In view of the possible detrimental effects of
such hazards in the workplace, she should be advised to take a leave from work at least for the duration
of the pregnancy.

b. Make a plan of care for her utilizing the nursing process.

ASSESSMENT DIAGNOSIS INTERVENTION EVALUATION

6 months pregnant, on Risk for injury related 1. Adequately After three days, the
on-going treatment presence of assess the expectant mother shall
treatment for sexually occupational hazards hazards she is have made instituted
transmitted disease exposed to in discussed measures on
her work how to prevent injury
Experiencing many environment to her self and her child
physiologic symptoms 2. Discuss means or shall have made a
on how to avoid decision on whether or
such hazards not to take a leave from
and how to her job.
implement
them
3. If avoidance is
not adequate,
present to her
the need to
take a leave
from her job
4. Discuss to her
the pro and
cons of the
measure
5. Present to her
the steps to
take in carrying
out the decision
she has come to