Ob/Gyn Case Study
Case #2 Maria Bowman
Focus questions – Set I
1. What are the implications of this test?
An abnormal maternal serum alpha fetoprotein (triple screening test) may reflect genetic predisposition for Down’s syndrome (Trisomy 21) or Edward’s syndrome (Trisomy 18). Alpha fetoprotein is also increased in amniotic fluid in pregnancies associated with open neural tube defects (ONTD) such as Spina Bifida that allow the fluid to leak from the fetus into the amniotic fluid. The implications of positive test results sometimes point to a possible termination of pregnancy, or the need for an additional testing.
2. When is this test normally done?
The AFP test is generally done between the 14th and 21st weeks of pregnancy.
3. Since this test was abnormal, what additional tests might the nurse anticipate being ordered?
Abnormal test results of AFP may indicate the need for additional testing. Usually an ultrasound is performed to confirm the dates of the pregnancy and to look at the fetal spine and other body parts for defects. An amniocentesis may be performed to assess for elevated amniotic fluid levels of AFP and other chemicals which may indicate the presence of spina bifida.
4. How might Maria’s cultural background affect the nurse-client relationship and what might the nurse do to become more culturally competent?
Maria cultural background my affect her decision regarding TOP, she may opt not to terminate pregnancy. Nurse can reflect intercultural sensitivity by examining her understanding of the different ways she can behave when she is interacting with Maria, her open-mindedness concerning the differences she encounters while caring for Maria, and her flexibility concerning behaving in unfamiliar ways that are called upon by the norms of Maria’s culture. The nurse should be able to modify specific behavior so that it is appropriate to her client’s culture, so that she will have a greater chance of achieving her outcomes.
Focus Questions –
Focus questions – Set I
1. What are the implications of this test?
An abnormal maternal serum alpha fetoprotein (triple screening test) may reflect genetic predisposition for Down’s syndrome (Trisomy 21) or Edward’s syndrome (Trisomy 18). Alpha fetoprotein is also increased in amniotic fluid in pregnancies associated with open neural tube defects (ONTD) such as Spina Bifida that allow the fluid to leak from the fetus into the amniotic fluid. The implications of positive test results sometimes point to a possible termination of pregnancy, or the need for an additional testing.
2. When is this test normally done?
The AFP test is generally done between the 14th and 21st weeks of pregnancy.
3. Since this test was abnormal, what additional tests might the nurse anticipate being ordered?
Abnormal test results of AFP may indicate the need for additional testing. Usually an ultrasound is performed to confirm the dates of the pregnancy and to look at the fetal spine and other body parts for defects. An amniocentesis may be performed to assess for elevated amniotic fluid levels of AFP and other chemicals which may indicate the presence of spina bifida.
4. How might Maria’s cultural background affect the nurse-client relationship and what might the nurse do to become more culturally competent?
Maria cultural background my affect her decision regarding TOP, she may opt not to terminate pregnancy. Nurse can reflect intercultural sensitivity by examining her understanding of the different ways she can behave when she is interacting with Maria, her open-mindedness concerning the differences she encounters while caring for Maria, and her flexibility concerning behaving in unfamiliar ways that are called upon by the norms of Maria’s culture. The nurse should be able to modify specific behavior so that it is appropriate to her client’s culture, so that she will have a greater chance of achieving her outcomes.
Focus Questions –