Clinical Chart Review
The following Family Case Report took place in a clinical setting from 20thth September to October 12th, 2016. The time spent with the family was two weeks; hence, providing a perfect period to collect the required data. The family is a friend of my family, and after presenting them with the letter of consent, they humbly agreed to my request.
The patient is a woman aged 36 years and named Linnet. She had given birth six weeks before the interview. Her GTPAL analysis shows that G=3, T=2, P=1, A=1, L=2. The analysis means that Linnet had a total of 3 pregnancies, 2 term deliveries, 1 preterm delivery, 1 miscarriage and 2 living children. Linnet’s first baby was delivered through vaginal delivery while she was 30 years old while the second was delivered through the cesarean section. Her first delivery did not have any complications but the second one presented a few problems.
The client has had only one delivery before that was normal without any induced labor. The postpartum experience for the client after the past delivery had a few complications due to a bacterial infection in the uterus. Since it was her first time, Linnet suffered from postpartum anxiety and stress that were initiated by the infections. However, investigations presented that the infection was caused by the contamination of the hospital bed due to increased patient numbers at the time. The infant, now Audrey, did not experience any complications during the postpartum period.
Period during pregnancy
Family members include Linnet's husband George, their firstborn daughter Audrey and Linnet's parents. However, only George and Linnet were present during the interview and assessment. The first impressions of this family were a loving and healthy couple that had endured during the pregnancy and delivery period together.
The father, George, is aged 39 is a software engineer and has a master’s degree in computer science. His work description assists during pregnancy periods because he can work at home before getting his paternal leave. Linnet, on the other hand, works as a cashier in a nearby financial institution. Their careers have a major contribution to their financial stability.
Physical assessment of the mother showed healthy signs despite the prenatal stress. However, she seemed weak due to the scar that she underwent during the cesarean delivery. In addition, assessment of the breast showed that they were engorged and that she required pain medications. However, they were full, and the milk production was normal. According to doctor’s reports, the assessments on the lochia and fundus presented normal conditions; hence, the lack of infections. She was thrilled and requested interactions with the newborn that changed her emotions. The mother’s emotions would change during the interview, a sign that the delivery process made situational changes that would change in time. The father was also notified of the changes in emotions that may come up after leaving the hospital. However, during the six-week period, the mother was health and not moody as she was a few weeks after giving birth.
Analysis of the Assessments, Observations, and Interview
The newborn baby was constantly assessed physically to ensure that he is health. The cord healed as expected while the sleeping pattern was regarded to be above normal. The feeding pattern depended on the sleeping intervals to ensure that he was healthy rather than being waking up the baby to breastfeed him. Upon weight assessment, the baby measured seven pounds after birth. He started feeding normally, and the weight gain was transitional with the doctor's recommendations.
The adequacy of the home environment for the growing family is perfect according to the observation. George’s family lives in a safe and quiet suburb; hence, these qualities will help in raising the newborn. Moreover, there is also plenty of space in the family home for the kid to play and walk around as he grows up. The presence of competent clinics offering postnatal services in the family’s environment will assist in postnatal checkups (Klossner & Hatfield, 2006).
Concerning family communication patterns, the family observed a consensual pattern of communication. According to George, the rules were set after marriage to ensure that everyone’s idea is represented in family decisions. As a result, there is constant and open communication that assists in periods such postpartum that require more urgency (Westall & Liamputtong, 2011). The pattern also adheres to conformity among the family members until an issue is resolved or requires external assistance.
Responsibilities within the family have been equally set to prevent exploitation of one family member. George has the power in his family but has to consult Linnet before making a decision. Financial decisions and chore allocation to a nanny are controlled by the wife since she has experienced from the first birth.
Family values in George's family are portrayed regarding high attributes of respect, humility, and kindness. Such aspects show that the members have fewer arguments due to prior understanding of the consequences. As a result, the newborn will enjoy life in the family without setbacks such as violence, abuse, and divorce.
About George’s family ability to meet affective needs, the wife claimed that there were funds set aside for this purpose. The affective needs may require funds to be perpetrated such as taking the kids out to show their affection. In the case of extra needs, her parents would be supportive to ensure a happy extended family.
The family’s need to meet socialization needs was based on the family values and communication patterns. The client has emphasized on communication that is a core aspect of socialization. Socialization may occur during family dinners and outings where one may raise an issue. External socialization by the child occurs but under monitoring from the parents.
Concerning healthcare needs, the client claimed that they had purchased insurances and banked funds to assist in emergencies especially with the newborn baby. Additionally, the healthcare centers in the family’s environs are cost effective; hence, enhancing healthcare needs. The presence of the first-born provided the client with experience and the benefits to come up with such insurance purchases.
Stress is family’s enemy especially in the modern society (Linnard-Palmer & Coats, 2016). The client's family has tried its best to avoid stress before there are repercussions that would affect their kids. To cope with the everyday stressors, the family ensures that there are backup strategies to prevent the stress. For instance, financial stress may be prevented by having backup cash for emergencies. Stress from the child and postnatal depression are prevented by ensuring a conducive environment that does not facilitate stress. Prior preparation for such postnatal periods especially for George assists a lot because the wife may become moody.
The father was excited and enjoyed his paternal leave to assist the mother with some chores before hiring a nanny. Audrey was so excited to have a new member of the family. She could not wait for hold him after visiting the mother in the hospital. Linnet's parents were also excited with the successful delivery since the previous pregnancy ended in a miscarriage. Clothes and other needs for the newborn child had already been purchased together with Linnet's needs to help in her recovery.
The collected data shows specific descriptions and characteristics of the family; hence, serving the purpose of this report. Also, the report can be used as a recommendation to an upcoming family that wants to have a baby. However, despite the prior experiences of prenatal and postpartum experiences, there are some situations where George's family requires changing and implementing new policies.
Emotional stress of Linnet
Firstly, the family requires more teaching in the handling of stress due to its indirect consequences. For example, Linnet's second pregnancy did not last long due to the miscarriage. From the interview, the family faced setbacks that led to the emotional stress of Linnet resulting in the loss of the baby. Lessons learnt from George's family experience are that life comes above all relationship goals. Consequently, couples should engage in stress prevention and management classes to ensure that there is reduced stress during prenatal and postnatal periods. In the long-run, the reduced stress enhances love towards the child leading to a healthy and happy life for the family.
According to the client, postpartum anxiety can be decreased by having a family member to help or hiring a nanny to assist in the postpartum period may be important but one has to ensure that they are provided with the infant details. The company and assistance provided assist the mother to relax with beneficial results during breastfeeding.
Recommendations for the family include stress reduction at home and role allocation to the husband. The schedule will assist in remembrance of the specific dates that the baby has to be taken for normal checkups and reduce anxiety (Linnard-Palmer & Coats, 2016). Hygiene should also be observed by George’s family to reduce the chances of infection before the child’s immune system becomes stronger (Westall & Liamputtong, 2011).
Klossner, N. & Hatfield, N. (2006). Introductory maternity & pediatric nursing. Philadelphia: Lippincott Williams & Wilkins.
Linnard-Palmer, L. & Coats, G. (2016). Safe maternity and pediatric nursing care. Philadelphia: F.A. Davis company.
Westall, C. & Liamputtong, P. (2011). Motherhood and Postnatal Depression: Narratives of Women and Their Partners. Dordrecht: Springer Verlag.
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