Postpartum Case Study # 1

Objective:

• Discuss and review case study with supervisor to involve student in the decision making realities of the home care setting.
• Case study is to be used as a basis for conference with a supervisor and/or peer group.

Patient Presentation

Hope Heart is a 35 year old female who will be having a postpartum home care visit. She is 3 days postpartum. Upon calling to schedule the home visit Mrs. Heart reports she has had a low grade fever, chills, n/v, increasing pain and some discharge from her incision site.

Upon arrival to her home you find her in a very teary state. She tells you she has not been able to stop crying, she is in pain, fatigued, and does not want to deal with anything.

History

Mrs. Heart has been married for five years. This is her first birth. She had a cesarean delivery secondary to failure to progress. She had prenatal care starting in the first trimester and had an unremarkable pregnancy. She has a good support network from her husband, family and friends. She has had an episode of a MRSA positive wound in the past.

Review

• What are Mrs. Heart’s risk factors?
• What are her strengths?
• What would you include in your subjective assessment?
• What would you include in your review of systems?
• What will you include in your physical assessment?
• What will you include in your psycho-social assessment?
• Why and when would you check in with her provider?
• What anticipatory guidance would you include in your visit?
• What plan of care would you propose to Mrs. Pregnant and her provider for further home care involvement?