CASE SCENARIO

• Liz Calhorn, an 18-year-old, is about 20 weeks pregnant(can’t remember

date of last menstrual period). Although she says
She knows she should have stopped smoking before pregnancy, she has
not been able to do this yet. Twice during the pregnancy (at the 4th and 10th
week), she drank beer at summer picnics. today, AT A CLINIC VISIT, SHE
TELLS YOU SHE HAS FELT HER FETUS MOVE. SHE STATES, ‘FEELING
THE BABY MOVE MADE ME REALIZE THERE’S SOMENE INSIDE ME,
YOU KNOW WHAT I MEAN? IT MADE ME REALIZE ITS’S TIME I
STARTED BEING MORE CAREFUL WITH WHAT I DO ‘LIZ WORKS AT A
FAST-FOOD RESTAURANT. BOYFRIEND (FATHER OF FETUS) IS
SUPPORTIVE BUT HAS NO MONEY TO OFFER HER FOR SUPPORT.
PATIENT STATES, ‘I’M NOT GETTING MARRIED. JUST NOT READY FOR
THAT LEVEL OF COMMINTMENT YET.’
 Assessment
SUBJECTIVE:
1. ”Feeling the baby
move made me realize
there’s someone inside
me, you know what I
mean? It made me
realize it’s time I started
being more careful with
what I do.”
2. ”She said that she
should have stopped
smoking during
pregnancy, and she has
not been able to do this
yet.”
3. Patient states that “I’m
not getting married. Just
not ready for that level of
some commitment yet”
Diagnosis Planning Intervention Rationale Evaluation
Ineffective Childbearing SHORT TERM: INDEPENDENT: INDEPENDENT: SHORT TERM:
process related to After 3 hours of nursing
substance abuse intervention, the patient 1. Emphasize the 1. Assesses fetal growth After 3 hours of nursing
evidence by patient is will be able to: importance of maternal and development to intervention, the patient
not able to stop smoking well-being including reveal possibility of was able to:
and drinking alcohol. 1. Participate in learning discussion of nutrition, intrauterine growth
process about benefits regular moderate restriction or fetal 1. Participate in learning
of quit smoking and exercise, comfort alcohol syndrome and process about benefits
alcohol. measures, rest, breast future needs. of quit smoking.
care, and sexual activity.
2. Acknowledge the 2.Maternal pregnancy
possible risk factor complications and
caused by substance negative effects on the
abuse. developing of the fetus
are increased with the
3. Encourage the patient use of tobacco, alcohol,
to get plenty of sleep and illicit drugs.
and to drink 8 glasses of
water. 3. Water helps flush
nicotine and other
chemicals out of your
DEPENDENT:
body. Therefore, drinking
LONG TERM:
water in sufficient
After a months of 1. Give prenatal vitamin
quantities is a must for
nursing intervention the has folic acid, iron and
every smoker.
patient stop smoking calcium as prescribe.
and drinking alcohol .
DEPENDENT:
1. Folic acid helps
prevent neural tube
defects. These defects
are serious
abnormalities of the fetal
brain and spinal cord.
Iron supports the
development of the
placenta and fetus. Iron
helps your body make
blood to supply oxygen
to the fetus.