Ruba is a 39 years old, pregnant woman at 8 weeks gestation, and her husband, Ali, is 50 years old, arrives at antenatal clinic for follow-up. The couples have been married for 12 years. Ruba completes the initial paperwork, and the nurse notes the following obstetric history: G6 T0 P0 A5 L0 M0.  Ruba and Ali asked the nurse many questions regarding Down syndrome as Ali’s sister, recently, has a boy with Down syndrome.

1. What are the questions in the history taking are the highest priority for the nurse to ask, given Ruba’s obstetric history?

2.What are the initial prenatal assessment and screening tests would the nurse anticipate for Ruba at this antenatal visit?

3.What are the fetal screening and diagnostic procedures would the nurse anticipate for Ruba?

4.What are the possible screening tests can be performed to reassure Ruba and Ali regarding the possibility of having a child with Down syndrome?

5.As Ruba has many questions regarding her pregnancy, including the physiological and psychological changes, labor process and postpartum period. The nurse advice Ruba and Ali to attend antenatal classes.
List six topics should be covered in the childbirth preparation program that may help to answer Ruba’s inquiries.

6.After 7 months, Ruba is approximately 37 weeks gestation. She comes for antenatal follow-up visit complaining of backache, leg cramps, heartburn, constipation, and difficulty sleeping at night. Describe three nursing management for each Ruba’s complain (minor discomfort).