HS1207: Maisie, aged 41, is at the polyclinic for a prenatal check-up today. She is currently 12 weeks pregnant and has a history of 1 normal vaginal: Health Promotion Across the Lifespan Case Study, NYP, Singapore

Maisie, aged 41, is at the polyclinic for a prenatal check-up today.

She is currently 12 weeks pregnant and has a history of 1 normal vaginal delivery of a boy at 36 weeks of gestation in 2016 and 2 spontaneous abortions at 13 weeks of gestation in 2018 and 8 weeks of gestation in 2020.

You are the staff nurse attending to Maisie.
Gravida: 4, Para: 1 (G4P1)
Expected Date of Delivery (EDD): 9th January 2023
Height: 160 cm
Weight before current pregnancy: 75kg
Current weight: 80kg

Medical/surgical history: Femoral herniorrhaphy in 2021
Family history: Maisie’s father and mother have Type 2 Diabetes Mellitus
Blood Pressure: 130 / 78 mmHg
Pain score: 2 / 10 for lower backache
Urine dipstick test results: to collect

Maisie shares with you that she worries about:

• the growing fetus and pregnancy complications.
• antenatal screening and cost for pregnancy.
• the arrival of her newborn due to the lack of family support.

Your assessment/conversation with Maisie shows:

• she is inactive and rests on the sofa most of the time.
• she has no energy to cook for the family and eats out most of the time.
• she drinks 2 cans of energy drinks like Red Bull, 2 cups of bubble milk tea with 100% sugar, and 2 cups of coffee a day to stay awake.
• she has craving for sugary treats and desserts like cupcakes.
• she likes to eat desserts e.g., ice cream and chendol up to 4 times a week.
• she dislikes taking medications and often skips her multivitamin pills prescribed by the doctor as she wants to avoid the side effects.

Your assessment/conversation about her husband, Malcolm reveals:

• he has been working the graveyard shift for 10 to 12 hours a day.
• he works long hours, lacks exercise, eats unhealthy late-night meals, and sometimes skips meals.
• he is stressed and fatigued from the prolonged working hours and finds it hard to make ends meet.
• he smokes at home often and smokes about 25 cigarettes per day to stay alert and relieve stress.
• he loves to meet his friends for drinking sessions during off days and often drinks up to 5 cans of beer.

Your assessment/conversation about her 6 years old son, Mason shows:

• he does not eat fruits and vegetables and consumes fast-food three times a week or more.
• he does not like to exercise and has a body mass index (BMI) of 20.
• he grows up watching television regularly.
• the family resorts to online videos and games to keep him occupied at home.
• he sleeps about 7-8 hours a night.
• he skips school most of the time due to asthma and allergic rhinitis symptoms.
• he has difficulty paying attention in school.

Maisie is keen to adopt a healthier lifestyle for herself and her family but requires more information and guidance.