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Post response: Allyn McCarthy

You are writing for MASTER level online FNP nurse practitioner program. Discussion Boards are utilized to encourage student-to-student interactions.  These assignments will focus on assessment and evidence-based health promotion activities’u responding to Allyn McCarthy post

Your responses should be clear, accurate and in complete sentences.

When offering an opinion, please support it with specific references and evidence, when possible. Evidence is supporting information from research (medical website or scolerly article not older the 5 years) or specific real-life application from your work experience or prior coursework.

# I uploaded my initial post as attachment, so u know what I have said on my post.

 PLEASE do not just rewrite the post that your class meat wrote, please do PUT your opinion can agree or disagree with evidence please…please ….please do not use mayo clinical not accepted by school

Allyn McCarthy

According to ACOG (2019), any encounter with a nonpregnant individual with reproductive potential is an opportunity to offer counseling that will improve reproductive, obstetric, fetal and neonatal outcomes. For the couple coming to the office for a preconception consultation, a good starting point is asking when they want to become pregnant. At age 40, a woman may find it more difficult to become pregnant on her own, but is likely to go on to deliver a healthy baby (Standford Medicine, 2022). Family history would be helpful to know, but since she is adopted, thorough screening becomes the foundation. Discussion and screening appropriate for a preconception care conversation would cover the topics below (ACOG, 2019).

· Maternal medical issues. Medical issues such as diabetes, hypertension, hypothyroidism, mood disorders, or clotting disorders might require a change in medications during pregnancy and close monitoring.

·  A complete medication review

·Pregnancy history

·Fertility and physiological changes of pregnancy throughout a woman's reproductive age

·Substance use and abuse

· Infectious diseases. Live vaccines should not be administered during pregnancy. Vaccines needed such as varicella, and TDAP could be administered at this visit.  Additionally, the patient should be screened and tested for sexually transmitted infections, including HIV.

·Genetic disorders. This would depend on ethnicity (sickle cell, thalessemias cystic fibrosis, etc)

·Folic acid supplementation

· Intimate partner violence screening

· Nutrition, obesity, exercise and physical activity.

· Environmental and occupational exposures for teratogens

The Nurse Practitioner can provide safe and competent care for pregnant clients (or those trying to become pregnant) who are classified as low risk based on screening tests performed prior to pregnancy and during the prenatal period.

References

American College of Obstetrics and Gynecology [ACOG], & American Society for Reproductive Medicine [ASRM]. (2019). ACOG Committee Opinion: Prepregnancy counseling (762). American College of Obstetrics and Gynecology. https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2019/01/prepregnancy-counselingStandford Medicine. (2022). Older moms healthy babies. Stanford Medicine Children's Health. https://www.stanfordchildrens.org/en/topic/default?id=older-moms-healthy-babies-1-1901

Expert Solution

A healthcare provider must offer detailed counseling for couples seeking preconception advice. The discussion could involve the various methods for enhancing fertility and fetal and neonatal outcomes. A healthcare provider should focus on the client's maternal medical issues, substance use, pregnancy history, genetic disorders, a medical review, exposure to domestic violence, infectious diseases, and nutrition, among other factors that could directly or indirectly affect the conception process outcomes. These details help in protecting the child and mother to enhance their well-being. Thus, various factors should be determined concerning a client's health before conception, which helps improve the well-being of the mother and unborn child.

I agree with Allyn McCarthy's post as it comprehensively points out the most crucial details that should be considered during a preconception consultation session. The discussion is crucial as research indicates a lack of awareness about measures to enhance preconception health (Goodfellow et al., 2017). Offering professional guidance regarding preconception and conception health helps shape a child's future health. In addition, clients have different perceptions and attitudes towards preconception care resulting from a lack of adequate guidelines, pessimism about compliance, client/provider relationship, and clinical structure (Nacev et al., 2022). Furthermore, preconception consultation helps in promoting health education, assessment of risk factors, and early intervention to mitigate chances of poor outcomes, which reduces morbidity and mortality rates through proper management of chronic diseases, prevention of genetic disorders, prevention of neural tube defects, avoiding substance use and smoking, controlling weight, protection from toxic exposure, protection from harmful environmental exposures, and management of infectious diseases to avoid transmitting to the fetus (Garthwaite & Wilkes, 2018). Thus, preconception consultation is critical in determining the prenatal outcome if appropriately conducted and early interventions devised.

References

Garthwaite, H., & Wilkes, S. (2018). Preconception counselling. InnovAiT: Education and Inspiration for General Practice, 12(2), 85–92. doi.org/10.1177/1755738018812506

Goodfellow, A., Frank, J., McAteer, J., & Rankin, J. (2017). Improving preconception health and care: A situation analysis. BMC Health Services Research, 17(1). doi.org/10.1186/s12913-017-2544-1

Nacev, E. C., Greene, M. Z., Taboada, M. P., & Ehrenthal, D. B. (2022). Factors influencing provider behavior around delivery of preconception care. Maternal and Child Health Journal, 26(7), 1567–1575. doi.org/10.1007/s10995-022-03411-8 

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