Utilize at least two scholarly references per post. What did you learn from your experience with Motivational Interviewing this week that could help your peer better address the preventive guidelines for the women in the scenarios?
In the first scenario, a 34-year-old woman is 36 weeks pregnant. She has one child and this is her second pregnancy. The patient is complaining of shortness of breath and swollen ankles. She associates having the flu with her coughing for several days. While talking, she is noticeably out of breath. Upon reviewing her chart, she has a history of hypertension. She reported stopping her blood pressure medications when she found out she was pregnant and admitted to seldomly taking her pills in general. She does not think it is a big deal. The purpose of this discussion is to apply the technique of motivational interviewing with the female in the scenario. Positively influencing her as an Advanced Practice Nurse (APRN) will be discussed and my experience with motivational interviewing will be described.
During pregnancy, the diagnosis of hypertension will negatively affect the mother and her unborn baby if it is not appropriately controlled. De Chesnay and Anderson (2020), explains that a fatal condition called peripartum cardiomyopathy (PPCM), is heart failure that that arises in pregnancy. The woman can also be affected from the condition five months after pregnancy. It is possible that the patient in the scenario developed PPCM due to stopping her blood pressure medications, which should have been continued in order to manage and prevent exacerbation of the disease throughout her pregnancy. According to de Chesnay and Anderson (2020), a risk factor for PPCM is chronic hypertension that is left untreated.
While hypertension is a disorder that can appear during pregnancy, chronic hypertension is described as pre-existing hypertension that was previously diagnosed before 20 weeks of gestation. Pregnant women are monitored for hypertension during pregnancy due to the prevalence and impact on health (Braunthal & Brateanu, 2019). It is important for the patient to understand the effects and harms of untreated hypertension while pregnant, both to herself and her unborn child. As an APRN the severity of the situation will be brought to her attention. The goal of assisting her to make changes and therefore the right choice in adhering to her blood pressure medication, will be implemented through motivational interviewing. According to Li et al. (2020), motivational interviewing is a type of counseling that takes on a cooperative and patient centered approach with the goal of bringing about changes in behavior. This type of approach will be used as APRNs to positively affect the health of the patient.
Non-judgement and empathy along with other techniques are utilized by the healthcare professional or counselors during motivational interviewing. This generates an environment that will help patients to discover or realize variations between the objective and their existing behavior (Li et al., 2020). Motivational interviewing focuses on unearthing and resolving indecision, enhances perceived importance of change, and support patients to prepare and make change (Li et al., 2020). There are several benefits of using the technique of motivational interviewing. Pros of using this technique with the pregnant woman are supporting her in the decision process while empowering her to start taking her blood pressure medication, her health condition and symptoms will improve, and her health behavior will improve. The patient will also be allowed to set her own goal without being pressured to change (Hogden et al., 2012). Actively involving patients in treatment and decision making is positively connected to their goal (Li et al., 2020). Some disadvantages of using motivational interviewing with the patient are the time limit and the timely intervention that is needed for her situation. In addition, guidance and monitoring by a clinician is needed in her case (Hogden et al., 2012