Nursing Diagnosis for 32 week pregnant

[yelworc123]

Hi

Clinical scenario has 32 week gestation, healthy but for mild asthma, sometimes wheezes and doesn't use her albuterol for fear of harming baby. fundal height is 30cm, weight curve going down, she is normal bmi, pre pregant weight 130# now at 146#, complains of itchy foul smelling discharge, no protein in dipstick, BP pre pregant 100/60 now 114/70. FHR has accelerations and baby moves alot.

So, I think she has Bacterial vaginosis, but I am struggling with a priority diagnosis. I am thinking risk for preterm birth cos of the asthma, risk of IUGR cos of the fundal height and weight loss, although neither are significant. Knowledge deficit regarding not taking albuterol. Risk of insufficient placental perfusion. They are all risk diagnosis, cos i don't have any ultrasound info. Just want advice if I am on the right track??

[Eru Ilúvatar]

Hi

Clinical scenario has 32 week gestation, healthy but for mild asthma, sometimes wheezes and doesn't use her albuterol for fear of harming baby. fundal height is 30cm, weight curve going down, she is normal bmi, pre pregant weight 130# now at 146#, complains of itchy foul smelling discharge, no protein in dipstick, BP pre pregant 100/60 now 114/70. FHR has accelerations and baby moves alot.

So, I think she has Bacterial vaginosis, but I am struggling with a priority diagnosis. I am thinking risk for preterm birth cos of the asthma, risk of IUGR cos of the fundal height and weight loss, although neither are significant. Knowledge deficit regarding not taking albuterol. Risk of insufficient placental perfusion. They are all risk diagnosis, cos i don't have any ultrasound info. Just want advice if I am on the right track??

lady partsl Bacterial infections can cause induction of labor; so I think that would be your priority. Focus on that itchy, foul smelling discharge first.

[yelworc123]

yes, that would be my priority, the infection, but i am struggling with a diagnosis that focuses on the asthma too, and the loss of weight and borderline fundal height. i have one for risk for pre eclampsia, cos of asthma and rising BP. I am thinking risk for injury to fetus related to ineffective breathing pattern as evidenced by wheezing....

[rainmaker1215]

For me:

Impaired airway will lead to poor circulation, 2nd Priority infection, then knowledge deficit