Nursing Management of Pregnancy at Risk

Nursing management of labor and birth at risk

 Health Conditions and Vulnerable Populations

1. Nikki is a 17-year-old G1P0 at 33 weeks’ gestation. Nikki comes to the clinic today for her prenatal visit and you notice that her hair and clothing have the distinct odor of marijuana and tobacco smoke. You directly ask Nikki if she has been taking any other drugs besides marijuana. Nikki is surprised by the question and denies it. When you explain that you can smell it in her hair and on her clothing, she starts to cry and says, “Please don’t take my baby away from me.” After reassurance, Nikki further admits to sporadic binge alcohol consumption and smoking “pot” and cigarettes. She relates that she also consumes four to five caffeinated beverages per day. (Learning Objectives 10 and 12)

  1. Describe      how cigarette smoking, marijuana use, binge alcohol consumption, and      excessive caffeine intake can affect Nikki’s pregnancy.
  2. What possible affect’s are there to Nikki’s baby from the maternal ingestion of      these substances?
  3. Describe the nursing care you would provide for Nikki.




Nursing Management of Pregnancy at Risk




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Nursing Management of Pregnancy at Risk

Nursing management of labor and birth at risk

Pregnancy is an actual occurrence in a woman’s life requiring careful consideration and management, ensuring a healthy outcome for the mother and the baby. Various risk factors are increasing the likelihood of complications during pregnancy. The risk factors range from pre-existing medical conditions, including diabetes or hypertension, and lifestyle factors, like smoking or substance abuse (Ramlakhan et al., 2020). The healthcare team, such as the nurses, is responsible for identifying the risk factors early and managing them appropriately to improve outcomes. Nursing management of the risks during pregnancy involves a multidisciplinary approach, including careful monitoring, education, and intervention to prevent potential complications. This essay will explore the effect of cigarette smoking, marijuana use, binge alcohol consumption, and excessive caffeine intake on Nikki’s pregnancy, the possible effects on Nikki’s baby from the maternal ingestion of the substances, and the nursing care for Nikki.

The Effect of Cigarette Smoking, Marijuana Use, Binge Alcohol Consumption, and Excessive Caffeine Intake on Nikki’s Pregnancy

When one smokes a cigarette during pregnancy they can be allied with numerous pessimistic outcomes, including low birth weight, premature delivery, placental abnormalities and sudden infant death syndrome, and smoking during pregnancy can cause tissue damage in the unborn baby, particularly in the lung and the brain. Marijuana use during pregnancy can be toxic to the baby’s health, causing many severe problems for Nikki’s unborn baby. Nikki’s consumption of binge alcohol during pregnancy can cause deadly alcohol syndrome, resulting in physical abnormalities, cognitive defects, and behavioral problems. Taking excessive caffeine during pregnancy has been linked with an intensified risk of miscarriage, low birth weight, and preterm birth. It is crucial for Nikki to stop smoking cigarettes and marijuana, stop drinking binge, and minimize her intake of caffeine in order to get a healthy pregnancy and baby.

Possible Effects to Nikki’s Baby from the Maternal Ingestion of Substances

Motherly intake of substances like excessive caffeine, alcohol, tobacco, and marijuana during pregnancy can probably disadvantage the developing fetus. When parent exposes their unborn babies to marijuana can lead to impaired neurodevelopment, attention, and behavioral problems (Etemadi-Aleagha & Akhgari, 2020). When a pregnant woman starts smoking cigarettes, she can increase the risk of preterm labor, low birth weight, and even death of the infant, and also it can defilement tissues in the unborn babies. Women should stop the intake of alcohol during pregnancy as it can lead to fetal alcohol spectrum disorders causing physical, behavioral, and cerebral disabilities (Popova et al., 2018). Pregnant women consuming much caffeine can lead to miscarriage and low birth weight. Healthcare providers are responsible for educating pregnant women on the dangers of taking such substances on the developing fetus and providing them with cessation support.

The Nursing Care to Provide for Nikki

In Nikki’s case, the main focus would be to ensure that Nikki and her baby are safe. It would be essential for a nurse to provide emotional support and encouragement to Nikki, understanding that the nurse’s goal is to enable her to have a healthy pregnancy and a healthy baby. Nurses should encourage Nikki to be honest with them about her substance consumption, as assessing the possible risks and complications that may occur effectively is vital (Nicolini et al., 2018). A nurse should conduct a thorough assessment of Nikki’s health status, including her energetic signs, weight, and urine analysis, to screen for any potential complications that are usually associated with her use of a substance and also evaluate her mental health by referring her to a specialist if there is need for. For Nikki’s substance use, it would be appropriate to educate her on the possible risks linked with alcohol, tobacco, and marijuana use during pregnancy. A nurse would also be responsible for working with Nikki and developing a plan on how she could stop smoking and minimize her caffeine intake. A nurse should also work with other healthcare professionals, such as a substance abuse counselor or social worker, to offer additional support and resources for the patient (Hoeft et al., 2018). This may involve referring Nikki to substance abuse treatment programs, smoking termination programs, and support groups. A nurse should ensure that Nikki undergoes the appropriate care and support required for a healthy pregnancy and baby.


Nursing management of pregnancy at risk is essential in nursing as it ensures a healthy pregnancy outcome for both the mother and the baby. Nikki using tobacco, alcohol, marijuana, and caffeine put forward a significant risk to her pregnancy. Such substances can lead to complications like low birth weight, stillbirth, developmental delays, and behavioral problems in the baby. A nurse should not judge but should provide supportive care in helping Nikki overcome her substance use disorder. It would be appropriate to provide education on the risks associated with substance use while pregnant, and other nursing interventions would also appropriate. Early intervention and continued support would enable the nurse to ensure that Nikki and her baby get the best possible outcome.




Etemadi-Aleagha, A., & Akhgari, M. (2022). Psychotropic drug abuse in pregnancy and its impact on child neurodevelopment: A review. World Journal of Clinical Pediatrics11(1), 1.

Hoeft, T. J., Fortney, J. C., Patel, V., & Unützer, J. (2018). Task‐sharing approaches to improve mental health care in rural and other low‐resource settings: a systematic review. The Journal of rural health34(1), 48-62.

Mattson, S. N., Bernes, G. A., & Doyle, L. R. (2019). Fetal alcohol spectrum disorders: a review of the neurobehavioral deficits associated with prenatal alcohol exposure. Alcoholism: Clinical and Experimental Research43(6), 1046-1062.

Nicolini, M., Vandenberghe, J., & Gastmans, C. (2018). Substance use disorder and compulsory commitment to care: a care‐ethical decision‐making framework. Scandinavian Journal of Caring Sciences32(3), 1237-1246.

Popova, S., Lange, S., Probst, C., Gmel, G., & Rehm, J. (2018). Global prevalence of alcohol use and binge drinking during pregnancy, and fetal alcohol spectrum disorder. Biochemistry and Cell Biology96(2), 237-240.

Ramlakhan, K. P., Johnson, M. R., & Roos-Hesselink, J. W. (2020). Pregnancy and cardiovascular disease. Nature Reviews Cardiology17(11), 718-731.

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