Pregnancy is a very important process for women and nursing students have the knowledge of pregnancy is very helpful for future nursing practice. This essay will first introduce the importance of informed consent. Some common discomfort symptom and the way of how to relieve will be listed. Then, the process from pregnancy until after childbirth of women will be discussed. The client has been chosen and part of the information will be based on the client’s experiences. After this, a full assessment for newborn baby will be listed and physiological changes will be discussed. It will also mention some support services in New Zealand. Finally, breastfeeding, bottle feeding and sterilisation of baby equipments will be mentioned. All appendixes will be attached at the back of the essay.
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Informed consent plays a vital role when people receive healthcare services or participate in researches and experiments. According to the Code of Health and Disability (1994), informed consent reflects client have their rights to be informed about all the information they should know thus to ensure they can freely make their decision (Ministry of health, 1994). There are three key factors to promote informed consent. First, communication effectively can help clients to have a good understanding of the information which has been provided (Health and disability commissioner, 2000). Second, providing all information including the therapeutic use and the side effects to ensure clients that clients make an informed decision. All the information has been provided have to follow honestly and accurately. Last, clients have the right to freely make their choices. Services can only be given to someone has signed an informed consent form (Health and disability commissioner, 2000). Clients also have their rights to refuse or stop any medical experiment (Health and disability commissioner, 2000). Overall, informed consent is to promote the clients rights and ensure clients have understand the whole process of any research or service. It also ensures the quality of the research and clients will fully participate in the project (Health and disability commissioner, 2000).
In this assignment, my client will be addressed as Mrs. F and her husband as Mr. F to ensure their confidentiality. The first visit to them was to introduce all the information of the procedures and explain the purpose of the project. Getting permission from my patient is also an important purpose for me to visit her. In addition, clients should know their rights before I start my project.
I introduced myself and the purpose for me to do this project to Mrs. F and Mr. F when I first visited them. Then, I explained all the details of this assignment to her, such as, what parts I would like to know from her and the time of visits. To obtain the informed consent from Mrs. F, I explained all her rights to ensure she feels secure to share her experiences and she could stop the interview at the any stage and all her information will be confidential. I also got permission from Mr. F as he is the baby’s father. After all the introduction and explanations, Mrs. F finally signed the consent form.
1b. Learning issues
The learning issue has attached in Appendix I of the assignment.
Pregnancy and birth
2a. Common discomforts of pregnancy and the way of relieving them.
There are many common discomforts for women during pregnancy. Knowing how to minimise and relieve the discomforts during pregnancy can benefit both mother and baby (Pillitteri, 2010). The common discomforts and the ways of relieving it will be listed in appendix II.
2b. Discomforts experienced by my client during her
Mrs. F had experience constipation, swollen ankle and urinary frequently during her pregnant.
First, constipation happens due to the pressure of baby growth against the bowel (Pillitteri, 2010). Mrs. F told me that she increased fibre intake in her diet, by eating vegetables grains and fruits to relieve constipation.
Second, swollen ankle is caused by the pressure from uterine to slow down the blood circulation (Pillitteri, 2010). Mrs. F’s ways of relieved this symptom are putting her legs on the chair when have a rest and doing some exercise to increase her blood circulation.
Finally, urinating frequently happens at the early and late stages of pregnant due to the pressure of baby growth against the bladder (Pillitteri, 2010). Mrs. F shared her methods of how to reduce the symptoms that is avoiding to take any drink contain caffeine. Mrs. F said those symptoms are bothering her at the beginning. However, it does not influence her normal life after she tried the methods above as it is meet a part of content in Appendix II.
By getting all the information, she searched online, such as Ministry of Health and some other reliable websites. She also got some suggestions from her midwife.
2c. Adjustment made during pregnancy by the mother and father.
There are some adjustments during the pregnant of Mrs. F between her and her husband. Mr. A started doing most of the housework, such as, cleaning, shopping and cooking. Mrs. F also resigned her job because she needs more time to rest. They got lots of helpful information from previous pregnant friends, midwife and website.
2d. Advices from the father.
Mr. A had some suggestions to other expectant fathers. Fully supporting their wife is one of the most important parts. For instance, do some housework and take care of his wife. Another thing is to encourage pregnant women do some exercise everyday to promote their wellbeing.
2e. Clients’ experience of childbirth.
Mrs. F had childbirth after 39 weeks and she had psychological preparation before her estimate date. She started having painful contraction first and her water broken after 30 minutes later. Then, Mr. F took her to the hospital immediately. Mrs. F felt the rhythm of contractions is getting frequent and she felt very exhausted. Finally, Mrs. F had a cesarean section due to the fetus position is inappropriate. Her husband was stayed with her and supported her during the whole process. She told me that she could not feel any painful during the cesarean section because of the anaesthetic injection. She got the most of information from her antenatal class, midwife and well child health book. For example, doing some walking could make the labour easier and prevent infection of her wound after a cesarean birth. The well child health book has lots of health information for mother to get will known of their baby and mother can document the development of the baby up to 5 years old.
Mrs. F made a simple birth plan as it was her first time of pregnant. The plan includes the hospital she preferred to go, the person she would like to stay with her during labour, her preferred way of having labour and some method to relieve her pain. Mrs. F said the most of the requirements from her plan has been met. However, there are some differences between the plan and the actual birth. For example, the painful relieve method was not very effective because the pain level is over her imagination.
2f. Father’s response to birth.
Mr. F was in expectation to see his baby. At the same time, he was very worried about his wife and baby’s health status during the labour. However, after he knew that they were well, he was very excited, cheerful and exhausted. He also felt very busy after Mrs. F gave birth because he has lots of other things to prepare.
2g. Learning issues.
The Appendix III has concluded all the new things that I have learnt from second visit.
3a. Client expectations of the puerperium and the actual experience
Puerperium is the time that around 6 weeks after the women give the childbirth. The most change in women during puerperium is physical. Mrs F. was expecting breastfeeding will be easy for her baby. However, she found placing her baby in the right position to breastfeeding was very difficult. After many times, she got used to it.
3b. Mr. F’s experiences of becoming father
Mr. F found his role has changed a lot after he became a father. He is concerned that his wife will get postnatal depression which is mood swing during the first 2 weeks after she gives childbirth. Evidence shows that 13 percent of New Zealand women easily get postnatal depression after childbirth. Sleep disruption is one of the factors could affect women (Plunket, 2012). Therefore, Mr. F took more responsibility to look after his baby during the night time to ensure his wife got enough sleep. Learning how to change diaper was also a challenge thing for him that he felt more and more responsibility he should take on his baby.
3c. Support and follow up care
There are many support services in New Zealand that provide information and help newborn parents. Lead Maternity Carer (LMC) and Well Child service provides support to pregnancy women. The detail will be listed in appendix VI. Mrs. F found her midwife is very helpful. She received a lot of information on breast feeding, showering and immunisation. It was not only beneficial for herself but also for the new born.
3d. Full assessment of the new born
A full assessment of the new born (head to toes) will be attached in Appendix IV.
3e. Physiological changes in the newborn
Physiological changes such as physiological weight loss, Meconium, Mongolian blue spots and physiological jaundice are explained in detail as appendix V. For a new mother, knowing the cause and the symptoms of physiological jaundice are very important. The way of managing this symptom is the mother should feed her baby every two to three hours. This could decrease the level of jaundice. If the symptoms do not disappear, parent should seek medical assistance (Medlineplus, 2011).
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3f. The Well Child book has many information and assessment of the newborn baby. The assessment includes Apgar, hearing, vision, weight, height, full physical examination and immunisation (Ministry of health, 2010). Birth assessments cover all of them. From first week to six week, the assessment concentrated on weight, vision, hearing, full physical assessment and health protection. From eight to ten week, the assessment has added the examination that includes skin and sleeping observation. During three to seven month, PEDS check will start assessing. Oral health assessment starts from nine month to three year old. B4 school check includes oral health, growth check, PDES and SDQ check. All this assessments is to ensure the normal development of the baby (Ministry of health, 2010). Documentation the information of newborn baby could help parents and health professionals observe the development of the baby and also identify the problems of the baby (Ministry of health, 2010). There are some ways for parents and health professionals to assess the hearing and vision of newborn. For 4 to 6 weeks old baby, hearing can be assessed by making noisy and the baby is able to response to it. The vision can be assessed by observing whether they will response to light. For 5 to 7 month old baby, hearing can be assessed by coping parent’s word. The vision can be assessed by placing toys in front of them to see if they will reach it (Ministry of health, 2010).
3g. The roles of plunket nurse
Plunket nurse works with family to look after the baby and provide information to the family. They provide services for the baby were born until the baby up to five years old. Plunket nurses have many roles. Firstly, they come to visit and assess the health of the new mother and her newborn baby. Secondly, they provide information to the parents and educate the new mother about breastfeeding, showering, immunisation and other basic needs (Skelton, 2012).
3h. Learning issues
The learning issue is attached as an appendix VI.
4a. Experience of feeding her baby
Mrs. F gave breastfed her baby up to 6 months. Her family, friend and midwife influenced her choices as they told her about the benefits of breastfeeding. Mrs. F gained a lot of information about breastfeeding and all her family and other health professionals offered her support. For example, the way of feeding, the time of feeding and the amount of feeding. She found the support very helpful as it made the breast feeding process a lot easier.
4b. Advantages and disadvantages of breastfeeding
The advantages and disadvantages of breastfeeding are attached as an appendix ……….
4c. The mother’s experience of breast feeding
Mrs. F breastfed her baby up to 6 months and she felt painful sometimes. Every time when she heard the baby cry, she put her finger on the baby’s lip and baby will lick mother’s finger. Then, Mrs. F will know that her baby is feeling hungry. When the baby felt full, he will stop sucking Mrs. F’s nipple. Mrs. F told me that she followed the signs most of the time and it was very helpful.
4d. To select an appropriate formula
The mother should choose the appropriate formula for their baby based on the age and allergic history. Some babies allergic to milk power due to their body have reaction with the protein in the milk formula. Therefore, parents should be very careful when they select formula for their baby (Kids with food allergies foundation, 2009).
4e. Process for safe cleaning and sterilisation of bottle, teats and other equipment
The Appendix VII will show all the details about safe cleaning and sterilisation method for baby production.
4f. The mother’s experience of bottle feeding and introduction of solid.
Mrs. F gave her baby breastfeeding topped up with formula. She found bottle feeding a lot easier and quicker than breastfeeding. However, adjusting water temperature was quite difficult for her.
The mother should have enough knowledge of solid food before providing it to her baby. The development and growth of the baby are the key considerations when supplying solid food to them. Solid food should be provided when baby is around 5 to 6 months old (Extension, 2012). The mother also needs to ensure that the baby is able to swallow solid food, digest solid food and sit straight. The ways of giving solid food are showed as following. Mother should make sure her baby is happy before giving solid food to him and provide solid food after giving breastfeeding or formula (Extension, 2012). Putting the baby on a feeding chair will be easy for mother to feed them. Mother should always give a small amount of food on the spoon when feeding them. Also, giving the baby enough time to swallow the food and get used to the new flavour. A mother should grasp all the knowledge of the time and the way to provide solid food as it will make the feeding process easier for her (Extension, 2012).
4g. The learning issue is given as appendix VIII.
I have learnt lots of new knowledge from this project. To prepare informed consent before interviewing my client and keep confidentiality are very important to establish the trust between us. Having the knowledge from pregnancy to birth will help me in the future when I am dealing with pregnant women. For example, I would able to give them some useful information during their pregnancy. I also can provide some New Zealand health services for them to ensure both mother and infant’s health. Time management is another important part that I have learnt. I wrote some questions before I go to visit my client because it is very helpful for me to have a clear idea when I interview my client. Controlling the time also help me to have an efficient conversation with my client as she will not feel so tired or hasted about our talking.
In conclusion, informed consent is very important for any research as people have the right to make their own decision. Mrs. F shared all her experiences from pregnancy until after childbirth and Mr. F also shared his experience of becoming a father. There are many common discomfort symptoms during pregnancy and relieved ways could help to reduce the uncomfortable level. LMC and Well child services provide lots of supports to pregnant women and they can get useful information from the services. The experience of this interview is helpful to the future nursing practice.
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