List of 3 Nursing diagnosis
Priority Nursing Dx
Subject /objective data
Intervention with rationals
N425: Health Assessment Lab
Pregnancy and Bruising
Case Study – Fall 2022
Sue, a petite 20-year-old Asian American, comes to the emergency department in preterm
labor. She is pregnant with her first baby and states that she is 7 months pregnant. She says
that she fell yesterday and that cramps started a few hours later. You note bruises on her jaw
and her right lower arm. She says her husband is away on a business trip and that she has no
family in town. You notice cigarettes in her purse and that she is very thin. When asked about
her weight, she states that she has “gained only 11 pounds” with this pregnancy. She states she
works as a waitress. She is quiet and only answers questions when asked.
She is stabilized in the emergency department and a transfer to the high-risk obstetric unit is
1. List three risk factors for preterm labor from the initial assessment of this patient?
Scenario Update 1:
As you wait for Sue’s transfer, you continue the admission assessment and physical
examination. When you listen to her heart tones you note a systolic murmur.
1. Is this a normal finding for this patient?
2. Provide rationale for your answer.
1. List 4 risks of smoking during pregnancy?
Scenario Update 2:
As you continue your examination, you note a number of bruises in various stages of healing
across the patient’s back, on her upper legs, and on her arms. You remember her coming in
wearing long sleeves even though the weather is warm. The bruise on her lower jaw is elevated
and very tender. When you ask about her fall, she answers vaguely that she slipped on a rug at
home. She offers no explanations for the bruises on her arms and legs or why she waited until
today to come in for help when she has had cramping since yesterday afternoon.
Page 1 of 2
1. What do these findings suggest?
2. Why is it routine to screen for intimate partner violence?
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