CHN Case Analysis Case Scenario

CHN CASE ANALYSIS
CASE SCENARIO
Zara is a 35-year-old sales lady who is happy to be pregnant for the first time at 5 weeks,
gestation. She goes to a walk-in clinic for a pregnancy test. The pregnancy is confirmed and
the SOGC booklet on healthy pregnancy is provided. She has read it and has questions. At
her first prenatal check-up, the health care practitioner asks, “When was the last time you had
a drink?” Zara replies, “Just a glass of wine with dinner.”
Make a plan of visit 1, 2, and 3 for the mother.
PLAN OF VISIT 1
IMPORTANCE OF ENVIRONMENTAL SANITATION
I. Demographic Profile
A. Name: Z. T. J.
B. Age: 35 years old
C. Sex: Female
D. Date of birth: May 19, 1985
E. Marital Status: Married
II. General Objectives

After 30 minutes of nurse-family client interaction, the family client will be able to
understand the importance of maintaining environmental sanitation.
III. Specific Objectives
After 30 minutes of nurse-family client interaction, the family client will be able to:
a. Define environmental sanitation
b. Know the factors which impact on the infectious agents and transmission of disease
c. Know the sanitation practices
d. Know the diseases associated with poor sanitation
e. Know the benefits of sanitation
IV. MATERIALS
 Visual Aid
 Brochure
V. ACTIVITY
 Interactive Discussion
VI. HEALTH TEACHING

WHAT IS ENVIRONMENTAL SANITATION?
-Environmental sanitation is the promotion of hygiene and the prevention of disease and
other consequences of ill-health, relating to environmental factors
FATORS THAT IMPACTS ON THE INFECTIOUS AGENTS AND TRANS
MISSION OF DISEASE
 Disposal of human exreta
 Sewage
 Household waste and other waste likely to cantain infectious agents
 Water drainage
 Domestic water supply
 Housing
SANITATION PRACTICES
 Personal hygiene (washing, dressing, eating)
 Household cleanliness (kitchen, bathroom cleanliness, dusting)
 Community cleanliness (waste collection)
DISEASES ASSOCIATED WITH POOR SANITATION
 Cholera
 Diarrhea
 Dysentery
 Hepatitis A
 Typhoid
 Polio
BENEFITS OF IMPROVING SANITATION
 reducing the spread of intestinal worms, schistosomiasis and trachoma, which are
neglected tropical diseases that cause suffering for millions;
 reducing the severity and impact of malnutrition;
 promoting dignity and boosting safety, particularly among women and girls;
 promoting school attendance: girls’ school attendance is particularly boosted by the
provision of separate sanitary facilities; and
 potential recovery of water, renewable energy and nutrients from fecal waste.
PLAN OF VISIT 2
BENEFITS OF BREASTFEEDING AND GOOD ATTACHMENT
A. Name: Z. T. J.
B. Age: 35
C. Sex: Female
D. Date of birth: May 19,1985

After 30 minutes of nurse-family client interaction, the family client will be able to know
the benefits of breastfeeding and proper attachment
III.Specific Objectives
a. Know the benefits of breastfeeding to infants
b. Know the benefits of breastfeeding to mother
c. Know the benefits of breastfeeding to family
d. Know the signs of good attachment
IV. MATERIALS
 Visual Aid
 Brochure
V. ACTIVITY
 Demonstration
VI. HEALTH TEACHING
WHY IS BREASTFEEDING IMPORTANT?
-Breastfeeding is important because it keeps the baby healthy. Breastmilk is the ideal food for
infants. It is safe, clean and contains antibodies which help protect against many common
childhood illnesses. Breastmilk provides all the energy and nutrients that the infant needs for
the first months of life, and it continues to provide up to half or more of a child’s nutritional
needs during the second half of the first year, and up to one third during the second year of
life. While it fives the infant a lot of benefits, it also has benefits for the mother as well as the
family.
BENEFITS OF INFANT
1. Natural source of nutrients necessary for optimal growth and development during the
first 6 months
2. Decreased incidence or severity of infections such as GI and respiratory infections,
otitis media, necrotizing enterocolitis, gastroenteritis, meningitis, and urinary tract
infections
3. Potential protective effect against sudden infant death syndrome (SIDS)
4. Potential protective effect against childhood and adult-onset diseases such as insulin-
dependent diabetes, allergies, asthma, lymphoma, ulcerative colitis, and adult-onset
hypertension
5. Less gastric reflux and constipation than formula feeding
6. Potential for enhanced cognitive development
BENEFITS TO MOTHER
1. Enhanced uterine involution resulting in less postpartum blood loss and reduced risk
of infection
2. Delayed resumption of ovulation that may facilitate family planning
3. Association between earlier return to pre-pregnancy weight compared with women
who do not breastfeed
4. Reduced risk of osteoporosis, ovarian cancer, premenopausal breast cancer, and
rheumatoid arthritis
5. Enhanced mother-infant bonding, maternal role attainment, and self-esteem
BENEFITS TO FAMILY
The entire family can reap benefits when mother and baby are nursing. It can be a time of
learning and closeness for older children and for the father.
1. Breastfeeding promotes spontaneity and the freedom to come and go without having
to pack formula and bottles
2. The breastfeeding mother feels good about herself which can help provide a happy
family environment
3. The family can be assured that the baby is being taken care and getting what it needs.
SIGNS OF GOOD ATTACHMENT
The word “attachment” describes how the baby’s mouth takes the breast. The key to a
successful breastfeeding is good attachment that’s why it is important to determine what are
the signs of proper attachment.
1. More areola/ nipple is seen above the baby’s top lip than below
2. Baby’s mouth is wide open
3. Lower lips is turned outward
4. Baby’s chin touched the mother’s breast
PLAN OF VISIT 3
BAD EFFCTS OF ALCOHOL DURING PREGNANCY
A. Name: Z. T. J.
B. Age: 35
C. Sex: Female
D. Date of birth: May 19,1985

After 30 minutes of nurse-family client interaction, the family client will be able to
understand the bad effects of alcohol during pregnancy
III.Specific Objectives
a. Know the potential risk of alcohol consumption during pregnancy
b. Know the teratogenic effects of alcohol
c. Common characteristics of children with Fetal Alcohol Syndrome (FAS)
d. Know tips to avoid alcohol during pregnancy
IV. MATERIALS
 Visual Aid
 Brochure
V. ACTIVITY
VI. HEALTH TEACHING
Approximately 1 in 12 women reports drinking during pregnancy, and 1 in 30 pregnant

women reports having five or more drinks on any one occasion during pregnancy
POTENTIAL RISK OF ALCOHOL DURING PREGNANCY
1. Alcohol passes easily across the placenta meaning the alcohol in the mother’s blood
passes to the baby through the umbilical cord.
2. Drinking alcohol during pregnancy can cause miscarriage and stillbirth
3. During the first trimester, it is believed to affect cell membranes and alter the
organization of tissue, causing structural defects
4. Throughout pregnancy, alcohol interferes with the metabolism of nutrients and thus
retards cell growth and division
5. Drinking in any amount and at any time may cause adverse fetal effect
TERATOGENIC EFFECTS OF ALCOHOL

The teratogenic effects of alcohol include Fetal Alcohol Syndrome (FAS) which is
characterized by 3 clinical features:
1. Prenatal and postnatal growth restriction
-growth restriction is noted in length, weight, and head circumference.
2. CNS impairment
-includes intellectual impairment, learning disabilities, high activity level, short attention
span, and poor short-term memory.
3. Recognizable combination of facial features
-Common facial anomalies associated with FAS include microcephaly, short palpebral
fissures, epicanthal folds, flat midface with a low nasal bridge, indistinct philtrum, and
thin upper lip.
COMMON CHARACTERISTICS OF CHILDREN WITH FAS

 Abnormal facial features
 Small head size
 Shorter than average height
 Low body weight
 Poor coordination
 Hyperactive behavior
 Poor memory
 Speech and language delays
 Intellectual disabilities
 Vision or hearing problems
 Problems with heart, kidney, and bones
TIPS TO AVOID ALCOHOL DURING PREGNANCY

1. If you are in a situation where drinking is involved, have a non-alcoholic drink that
you enjoy
2. Do activities that you enjoy to distract yourself
3. Discover new hobbies such as reading books or gardening
4. Ask support from family and friends
5. Attend seminars or mother’s class
6. If you find it hard to stop drinking, get help and contact your healthcare provider

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CHN CASE ANALYSIS

IMPORTANCE OF ENVIRONMENTAL SANITATION

II. General Objectives

VI. HEALTH TEACHING

BENEFITS OF BREASTFEEDING AND GOOD ATTACHMENT

II. General Objectives

VI. HEALTH TEACHING

WHY IS BREASTFEEDING IMPORTANT?

BAD EFFCTS OF ALCOHOL DURING PREGNANCY

II. General Objectives

VI. HEALTH TEACHING

Approximately 1 in 12 women reports drinking during pregnancy, and 1 in 30 pregnant

TERATOGENIC EFFECTS OF ALCOHOL

COMMON CHARACTERISTICS OF CHILDREN WITH FAS

TIPS TO AVOID ALCOHOL DURING PREGNANCY

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