65k 3 Assignment 1: Complicated Pregnancy

Instructions

You are caring for a 37-year-old woman who is pregnant with her second child. Her first pregnancy was traumatic as she experienced a pelvic fracture during delivery causing excruciating pain. Also, during this time she became addicted to opioids and has continued on buprenorphine during this second pregnancy. The anxiety from these memories plagues her. She is fearful that she will not be given adequate pain medication during the birth and that the baby may experience withdrawal symptoms. She has been prescribed an antidepressant for anxiety and depression. Her husband is a pharmacist and has attended most visits with the psychiatric-mental health NP for counseling and psychopharmaceutical drug management.

• What would be your initial approach to assessment and diagnosis with this patient and her family?
• Would you prescribe an antidepressant? If so, which one? What are possible adverse reactions to placing a woman on antidepressants in the postpartum phase?
• Explain the pharmacodynamics, pharmacokinetics, contraindications, pregnancy-related issues, legal/ethical considerations, testing (if applicable), side effects, and relationship to trimester.
• What would be your plan of care including the strengths and weaknesses of the family functioning and supporting attachment? (Be succinct.) Consider any supervision/collaboration/type of psychotherapy or complementary modality you might use.

Criteria for this paper:

• Answer these questions succinctly but completely, integrating resources to provide rationale for all decisions.
• Use APA formatting for all components of your paper.
• Your paper should be approximately three to four pages long and in APA format.
• Your paper length should not include the reference page.
• Use at least one nursing journal reference from CINAHL (available through the Regis library) to support your rationale.