Pregnancy at 30 weeks of gestation

  Case Study: Elizabeth Fong Scenario: Elizabeth Fong is a 37-year-old primigravida with a twin pregnancy at 30 weeks of gestation. She arrives at the prenatal clinic for her regular checkup. Elizabeth reports that during the past several days she has been experiencing low back pain, difficulty breathing, and the sensation that her abdomen has “expanded.” She complains of fatigue and difficulty finding a position of comfort while resting. Elizabeth states that the twins are active. Elizabeth’s fundal height measures 36 centimeters. The fetal heart rates are as follows: Twin A = 140 bpm; Twin B = 134 bpm. Elizabeth’s laboratory data from 1 week ago reveal the following findings: Hemoglobin: 9.2 g/dL. Serum ferritin level: 10 mg /dL. 1-hour glucose challenge test: 130 mg/dL. A sonogram performed during this visit shows a closed cervix, normal fetal growth, and excessive amniotic fluid. Critical Thinking Questions 1. What is the priority nursing diagnosis at this time? 2. What are the expected outcomes associated with this diagnosis? 3. Describe the teaching/learning needs related to the scenario that correspond to the priority nursing diagnosis. 4. List interventions with rationales that correspond to the priority nursing diagnosis.