RISK FOR DISTURBED MATERNAL–FETAL
At risk for disruption of the symbiotic maternal–fetal dyad as a
result of comorbid or pregnancy-related conditions
• Complications of pregnancy (e.g., premature rupture of
membranes, placenta previa or abruption, late prenatal care, multi-
• Compromised O2 transport (e.g., anemia, cardiac disease, asthma,
hypertension, seizures, premature labor, hemorrhage)
• Impaired glucose metabolism (e.g., diabetes, steroid use)
• Physical abuse
• Substance abuse (e.g., tobacco, alcohol, drugs)
• Treatment-related side effects (e.g., medications, surgery,
• Mental health status
• Cultural background
• Psychosocial issues
• Fetal well-being
ASSESSMENT FOCUS (Refer to comprehensive assessment parameters.)
The patient will
• Be compliant with recommendations for self-care activities to mini-
mize prenatal complications and optimize maternal–fetal health.
• Verbalize fears and uncertainty related to prenatal condition.
• Actively involve signiﬁcant other/support systems with pregnancy
expectations and plan of care.
• Demonstrate the “maternal tasks of pregnancy” culminating in an
unconditional acceptance of the fetus before delivery.
SUGGESTED NOC OUTCOMES
Prenatal Health Behavior; Knowledge: Pregnancy; Role Performance;
INTERVENTIONS AND RATIONALES
Determine: At each prenatal visit, assess physical condition,
psychosocial well-being, and cultural beliefs to be able to counsel
and/or refer as needed.
Perform: Encourage support/involvement of signiﬁcant other(s) dur-
ing course of pregnancy to enhance maternal role adaptation.
Incorporate the cultural beliefs, rites, and rituals of the childbear-
ing family into the plan of care to foster feelings of normalcy with
Inform: Educate patient/signiﬁcant other on role transition and
maternal tasks of pregnancy to provide anticipatory guidance on
expected psychosocial changes.
Teach trimester-speciﬁc risks/danger signs and emphasize
importance of self-monitoring to empower the patient and reduce
potential for adverse fetal effects.
Attend: Encourage patient to express disappointment/concerns
related to relationships, physical condition, and fetal well-being to
promote therapeutic communication.
Manage: Refer to community resources as needed (e.g., prenatal
classes, psychological counseling, pastoral care, social services) to
facilitate appropriate role adaptation.
SUGGESTED NIC INTERVENTIONS
Anticipatory Guidance; Childbirth Preparation; Coping
Enhancement; Role Enhancement
Olds, S., London, M., Ladewig, P., & Davidson, M. (2008). Maternal–
newborn nursing and women’s health care (8th ed.). Upper Saddle River,
NJ: Prentice-Hall Health.
Ward, S. L., & Hisley, S. M. (2009). Maternal–child nursing care: Optimizing
outcomes for mothers, children, and families. Philadelphia: F.A. Davis Com-