Tara
Tara (16) lives with her mum Julie (35) and step dad Tom (42) at the King’s Arms pub. Tara is 16 years old and is studying catering at the local Further Education College 5 miles away and also works part time alongside her mum and dad in the pub most evenings. They have rented the pub and adjacent house from a local brewery firm for the last 5 years. Tom never wanted to buy a house as being in the army he was used to moving around and was not sure he wanted to settle in any one place for a long time or even be a pub landlord. Julie was born locally and whilst she enjoys working in the pub admits it is hard work organising stock, serving and cleaning for little return.
All three smoke between 10-15 cigarettes a day. As Julie helps cook in the kitchen they also eat pub food most days as they work long hours.
- What benefits may Tara claim ?
- What specific health and safety issues should the midwife advise Tara about whilst pregnant in view of her job?
- Using a PISCES model think of one thing that may affect each of the following in relation to Tara’s wellbeing when you meet her today at antenatal clinic?
PHYSICAL
INTELLECTUAL
SOCIAL
CULTURAL
EMOTIONAL
SPIRITUAL
- Using the latest NICE Guidelines identify what are the key things the midwife needed to ask when Tara “booked” with her community midwife ?
- What other multi-disciplinary agencies could the community midwife encourage Tara and her family to contact to support them?
- How can a midwife allay her anxieties about going into hospital?
- What support services are available to the family with smoking cessation services locally?
Tara wants to attend parenting classes.
• What resources are available locally and nationally to support Tara in preparing for her baby?
She is very confused about all the antenatal screening tests on offer.
• List some of the screening tests that can be offered to Tara today?
Resources:
Review NHS choices website
https://www.nhs.uk/conditions/pregnancy-and-baby/screening-tests-in-pregnancy/
Review “Screening test for you and your baby” (Public Health England)
https://www.gov.uk/government/publications/screening-tests-for-you-and-your-baby
NICE Antenatal Care pathways
https://pathways.nice.org.uk/pathways/antenatal-care-for-uncomplicated-pregnancies
At her 28 week appointment you test a sample of urine but Tara complains of “stinging” and “itching” when she voids urine.
• What test would you undertake and what questions would you ask Tara to exclude or confirm a urinary tract infection (UTI)?
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- Tara goes into premature labour at 34 weeks.
List the possible causes of premature labour?
- She gives birth to Scarlett, weighing 2.4Kgs vaginally, after a precipitate labour at the local hospital accompanied by her mum, Julie.
Scarlett is admitted to the Neonatal Unit (NNU) where she stays for 10 days. She is transferred home after 10 days having gained weight and bottle feeding.
Scarlett was placed on a NEWS chart (National Early Warning Score NEWS) whilst in NNU.
- What financial help is available to help Tara visit Scarlett while she remains on NNU?