A woman in her second trimester continues to smoke a pack of cigarettes a day despite stating that she understands why smoking is bad for her and for her fetus. Which action by the nurse is best?
A.
Assess the patient for past trauma and abuse.
B.
Document the information in the patient's chart.
C.
Review prior teaching done regarding smoking.
D.
Show photos of babies born with abnormalities.
ANS: A
Research shows that women who continue to smoke during pregnancy often report high levels of trauma and abuse and higher levels of PTSD symptoms. Women who smoke as a coping mechanism are even more likely to smoke during pregnancy (Lopez, Konrath, & Seng, 2011). The nurse should assess for these factors. Documentation is important, but is not the best answer because the nurse does not do anything to assist the patient; documentation alone is the answer only when the data are normal. Reviewing prior teaching may be helpful, but if the nurse does not help the patient address the core issue of smoking, this review will be unhelpful and a waste of time. Showing babies born with abnormalities is demeaning and could be interpreted as threatening.
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